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y (� N <br />ar�m <br />p � M <br />7 H fn <br />� � �A <br />O C O <br />� N N <br />� H � <br />O N <br />z � d <br />� :° R <br />� H � <br />��� N H <br />y <br />tl N <br />��tra <br />H O N <br />�:y �< ... e t � av��� <br />""<� °�f�, ."x.� ���� v.,. ,,S n X^ 4 e:: �, t i 1j 4y1 .. .. <br />���Y��+�,5�` Sjii4�,��'�,.i �.t �`s'°�;irc .1 eP$"-w"'�.u�. ii�(��r�1'bS�` s ,�f ,�. <br />v'" s: x t <br />r� : <br />cj <br />Date <br />ppplication For <br />PUBLIC WORKS PERMIT <br />Print ar Type Only <br />�� `' PuCll<WorksParmiU _�� <br />oiep. oeo�� • <br />PuOM1e Wo�ka Feo § <br />Tolalfee <br />LessP00�FeePeiE S <br />Balenw Due $ <br />Plan Check No: H 37048 SEPA <br />Owner Applicat.Date: 06 16/92 <br />Job Addreae: 90 SE EVERETT MALL WAY 8B-2 <br />Owner: KURISU & FERGUS <br />Tenant: <br />qpplicant Propoeed Use: OFFICE <br />Deec. of Wurk: <br />T.Z. – ALTERATION OF INTERIOR WALLS – <br />1250SF <br />Describe Proposed Work — OFFICE SET <br />.'.OH SET <br />APPROVED FOR PERMIT: DATE�/_/ <br />Project Address (if knawn) <br />OAtach lour (4) copies ol plans for proposed work - Draw lo scale and note� Ceolerline ol tPeet`able: <br />• Property Lines • Indir,ale North <br />• Outline and dimensions ot all exisling and � Sh�w any F�Jposed grading changes <br />proposed structures on the lot • Show measurements <br />• Existing and proposed utilities � <br />Phone <br />Phone <br />PERMIT CONDITIONS <br />1. All calls tor inspection shall be made 24 hrs. in advance • phone 259•881 �• <br />2. All work shall be peAormed in accordance with this permit and current City of Everelt Design and Construction <br />Standards and Specitications. <br />3. Call Locatlon Undergrouna Service 48 hrs. betore you dig. TOLL FREE NUMBER 1•800•424•555 . <br />�U�i-ew GJazGi.✓ `Z2'L'.: �, � ///�1` �i�un.�J� �_ / �-9 Z <br />�B <br /><< .,::; <br />Approved for Construction <br />Date <br />Date <br />FINAL INSPECTION <br />qpproved as Conslructed <br />��r�PUBLICWORKSDEPARTMENT <br />3200 Cedar Slreet <br />Everett WA 98201 <br />Phone: 259-8810 <br />� <br />O <br />ACKNOWLEDGEMENT OF CONCIITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City ol Everett Irom any and all claims for damages, cos�s, <br />expenses, or causes ot aclion that may arise beca��se of installaticn <br />and maintenance ol the improvement or olher righ:�ol•way use herelo <br />applied lor and furiher agrees to remove same u�on notice irom ihe <br />Cily and to replace puhlic property damaged lherety. <br />Date <br />Signature ol ApP�icanl <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THER�AFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />