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Date 5/10/85 y"�'l � /� <br /> �) Pu�l¢Wo�ks Peimll• ✓—' S J <br /> Application For � ��jr1/ omg o�a�.• 85/1483 <br /> PlJBLIC WORKS PERMIT � PuelotalFenFce $ <br /> Less Ap0<<ee Paie $� <br /> Print or Type Only Ba���=Qo�e s 3�� � <br /> Everett Masonic Corp. 1611 Ev^_rett Avenue Everett 96201 252-6696 <br /> Owner Mailing Adtlrr.ss Cily Zip Phone <br /> Applicant Mailing Address Cily Zip Phone <br /> Construct 12'x28' Equipment Building and 100' hiqh antenna <br /> Describe Proposed Work <br /> W <br /> Proiecl Address(if knownl 2614 Wetmore � <br /> Attach four(4)copies of plans lor proposed work- Draw to scale nnd nole the following as applicable: � <br /> • P�operty Linea • Centerline ot sireet � <br /> • Outline and dimensions ol all existin�and • Indicale Norih <br /> proposed structures on ihe lot • Show any proposed�rading changes <br /> • Existing and proposed utilities • Show measuremenis � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1. All calls for inspeclio�i shall be made 24 hrs. in advance- phone 259-881 5. � <br /> 2. All work shall be perlxmed in accordance wilh this permit and current City ol EvereU Design and Construction <br /> Standards and Specilications. <br /> 3. Call Location Underground Service 48 hrs. belore you dig.TOLL FREE NUMBER �•800•424-5555. � <br /> ��. / ,�O'Ir /��I�O�L't� �� �"L�7s CJ'C//�� J� —�y — PJS� O <br /> � <br /> � <br /> � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> less the Clty ol Everett irom any and all claims lor damages, cosis, <br /> � �-� ezpenses, or causes ol action that may arise because ol installation <br /> �� .r�� and maintenance ol the improvement or other righl-of-way use hereto <br /> �� a�plied lor and lurther ac�rees to remove same upon notice Irom the <br /> Approved�r Construction Date City and to replace public property damaged thereby. <br /> ����"� 9-.21—�L <br /> FINAL INSPECTION Date �!�—` <br /> Approved as Construded Sign ture ol plicalSt Date <br /> everett PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> � 3200 Cedar Street 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everetl,WA 98201 BE DILIGENTLY PI IRSUED TO COMPLETION. THIS PERMIT MAV BE <br /> Phone:259•8815 CANCELLED BY THE:,ITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />