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� PUBLIC 1NORKS PERMIT °��� <br /> PUBLIC WORKS DEPMFT�AENT PubNe VW�M WmWI• <br /> 3200 Gdr Str�M —— <br /> Eve�sri,WA Yl201 26i-0l10 &�Akq Pr�Nt• <br /> TYPE OFi PRINT ONLY pubYc Works FM= <br /> plan Ch�ek No� B 53J62 siPA <br /> �"°r App11cat.Dal�� Ol/0.^./97 �N <br /> Job Addr���� 3020 RUCICER AVE <br /> Own�s� BNOHOMISH NEALTH DISTRICT <br /> Applicant T�nant: <br /> Piopo�W U��t OFFICS Phar <br /> De�c. of Mork: <br /> T.I. <br /> ����P►��� _ W <br /> OFlICE SET JOB 86T � <br /> APPROVBD !OR PBRMITs D11TE_/_/_ BY <br /> � <br /> _ � <br /> PRWECT ADDRESS pf known) � <br /> Attach lour(4)co�las W plvis for propoxd work-Drew to scela and mN tM Iolbwinp H appHcabls: <br /> 'Property Lines �putlina uM ChrNntlons ol W�zbtlnp erM proposed structuroa on tM bt 'Fxltlirq rk propossd utlittbs O <br /> �Cen1xNM ol shsM 'IndkaM North 5how!nY ProP�R�dkq ehnOn '3tqW Rls�surertMnM <br /> DO NOT WRITE BELOW THIS UNE � <br /> PERMIT CONDITIONS: � <br /> 1.Ail calls for inspection shall be made 24 hours in advance-phone 259-8810. O <br /> 2.All work shall be performed in ac:cordance with this pertnit and curtent City oi Everett Deelyn end <br /> Conshuct(on Standards and Speciflcations. <br /> 3.Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-000-424-6Q6E. � <br /> � <br /> O <br /> rUYLIC WORN� ����Y � <br /> NOT �my��� <br /> BY <br /> s,tTE 9 <br /> ACKNOWLEDOEMENT OF CONDfT10NS <br /> Th�underslpned ownxhppNcant M�aby piex to hdd and eaw hrrnl�� <br /> u�.ciry a�ve�c nan r�y ana�i cium.r«d.m.p.s,cwa,.zpraa,a <br /> Approved tor Constructlon pe�e u��a a�bn en.�ro.y.d�e�.w.a xnue.no�.nd nwm�,r,�.or <br /> thn Improvament a other rpM-ol-wq ua�hwNo�pplMd forand futl��p� <br /> to rertiove wns upon ratin hom tM Clty■nd ro repl�c�P��P�Y <br /> demaped therehy. <br /> FINAL INSPECTION Dete �' - <br /> Approved as Constructed <br /> Sprnture ot APP��+� Wts <br /> WORK AUT1iORIZED BY THIS PERMR MUST BE STAR7ED WITNIN 1B0 DAYS OF DATE PERMIT IS ISiUED AND TNERF.AFTER IS Tp BE pL1pENiLY PUR�IED TO <br /> COMPLFf10N.7HIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAOE OF WORK ON TIi13 PRQIECT OVER YO DAV$ptNiAT1pM, <br />