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Date ^ � <br /> Pu�Mc worw�parmil• <br /> ' Bkp.D�Dt• <br /> Applieation For <br /> PUBLI� WORKS PERMIT �°��W°�F� <br /> .�.�F.. : <br /> uu�oo�F«M�a f <br /> e.u�c.o�. s <br /> Print or Type Onty <br /> Owner Plan Check No: B 39783 SSPA Z'P PhO^e <br /> Applicat.Date: 03/05/93 <br /> 3ob 7lddraaa: 15i6 W6TMOR& AVB <br /> Owner: STRAIGHT HARK <br /> Applicant Tenant: zip Phone <br /> Proposed Ueez SFR/WORKSHOP <br /> Deec. of Works <br /> WORKSHOP <br /> Describe Propos^�Work . <br /> _ OFFICE SET JOB SST — - <br /> APPROVED FOR PERMITs DAT6_/_/_ BY <br /> - W <br /> Projer:t Addresa(if known) � <br /> Attecn tour(4)copiee ot plens lor proposed work•Draw lo acale anE note the foliowing as applicable: � <br /> • Property Lines • Centedine of atreet � <br /> • Outllne and dlmensions of sll exietinp anE • InCicete North <br /> proposed atructuros on the lot • Show�ny proposed pradlnq c�anpen <br /> • Exlntinp ond propoaad utilities • Show meaeurements � <br /> DO NOT WRITE BELOW TMI3 LINE O <br /> PFRMIT CONDITIONS <br /> t.A�I ull�for inepectbn ahall be m�ds 24 hrn.in edvancs-phone Z5�8810. � <br /> 2.AI�work ah�ll be perfamsA In accoMance with this permit�nd curtsnt Ciry of Evuett Desipn and Conatrudlon <br /> Stendards�nd SpeeHMatlona <br /> 3.Call Locetlon Underpround 3ervke 48 hra.before you dip.TOLL FREE NUM6ER 1-8004245S5S. � <br /> O <br /> � <br /> PUB NOTWREaU1RED MIT � <br /> BV B O <br /> DA7E �� �Z �s � <br /> ACKNOWLEDGEMENT OF CGNDITIONS <br /> The undersigne0 owner/applicant hereby apreea to hold and save harm• <br /> less Ihe City of Everett Irom any and all claims for damage0. coela <br /> ezpenses, or causes of action that mey erise beceuse of Installation <br /> and maintenance of the improvement or olher dphFoFway use hereto . <br /> applied lor and further agreas to remove same �pon nolice irom the <br /> Approved for Construclion Date City and to replace public property damaped thereby. <br /> FINAL INSPECTION Date I <br /> Approved es Constructed Signature of Applicant Date <br /> WORK AUTHORIZED BY THIS PERAIIT MUST BE STARTED WITHIN <br /> � PUBLICWORKSDEPARTMENT 780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS �TO <br /> 3200CederStreet BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAV BE <br /> EveretC WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259•BB70 pROJECT OVER 90 DAYS DURATION. <br />