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�erY�� ' >PPlicetion For � <br /> �UBLIC'.�ORKS PERMIT °� <br /> PUBLIC WORKS DEPARTMENT Public Nbrks Pertnit N <br /> 3200 Cedar Street <br /> Evereri,WA 98201 259-881U Bullding Pertnit M <br /> TYPE OR PRINT ONLY Pubik Works Fee S <br /> �ef �, Plan Check No: B 62007 SEPA Phone <br /> Appllcat.Date: 03/29 99 <br /> Job Addrss 8704 3 AVE SE <br /> Owner: BEREAN BIBLE FELLOWSHIP <br /> Tenant s phone <br /> Applicant � propoeed Uee: CHURCH <br /> Deec. of Work: <br /> CONNECT CHURCH AUILDING TO HOUSE FOR USE AS � <br /> Describe Proposed Work ED. WING (REV II 30-98) <br /> OFFICE SET JOB SET � <br /> APPAVD FOR PERMIT: DATE_/_/_ BY —_ — <br /> V� <br /> PROJECT ADDRESS(if known) -- /y� <br /> Attach luur(4)copies of plens tur proposed work-Draw to scale and note ihe following if applicable: O <br /> Rroper.y Lines 'Oulline and dimenslons of all ex(sting end proposed structures on the lol •Ezistinfl and proposed utilities <br /> 'Centerllna of street •Indicate North 5how eny proposed greding changes 5how measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: z <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-8810. O <br /> 2. All work shall be perFormed in accordance with this permit and current City of Everett Design and <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-6666. H <br /> V� <br /> O <br /> a <br /> 'UPLIC WORIcS NEPa�i � <br /> �iuT UUIRL"� <br /> :Y_��� . <br /> •ATE.__..__��-- <br /> 'f 5r � ACKNOWLEDGEMENTOFCONDITIONS <br /> The undersigned ownxdapplicent hereby agrees to hold end save hartnlass <br /> the Ciry of Everett fiom any and all clNms for damagas,costs,expenses,or <br /> causes of action that may erise because of installetbn and meintenenee of <br /> AppmvedforConstructlon Date I ;heimprovctneMorotherright-of-wayusahe�utoappliedtorandlurtheragrees <br /> to re�.iove ssme upon notice hom the City and to replace public property <br /> damaged therehy. <br /> FINALINSPECTION Date � <br /> Approved as Constructed <br /> Signature of Applieant Data <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STAHTED WITHIN 180 DAYS OF DATE PERNR IS ISSUEO AND TtIEREAFIER IS TO BE DILIGENTLY PURSUED�'0 <br /> COA1PLEf10N.THIS PERMIT AMY BE CANCELLED BY THE CIN UPON ANY STOPPACaE OF WORK ON THIS PF0.IECT OVER 90 DAYS DIIHATION. <br />