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� . � <br /> � 1�. <br /> � a <br /> � � <br /> � <br /> I <br /> � � � <br /> �� ��� Pu�I�c Wmka�arm�t• <br /> Cate�121l9J. <br /> ��� Appiication For aiav o�ot•_ 91/27040 = <br /> �� PUBLiC WORKS PERMIT PuOiicWoiheieo S <br /> � Tolaifee <br /> � I'saPp0l.FenPa�� S � <br /> ��� RtlancaDuo 5 <br /> Print or Type Only <br /> N�y <br /> Q�p �4erett Co�ncnity Nllege 801 Wetmore EVeret:t 98201 388-9253 <br /> ' �� Owner Mailing Address City Zip Fhone <br /> �y� <br /> � Design Plus <br /> M Applicant Meiling Address City Zip Phone <br /> w p I <br /> � Describe Proposed�Vork 2�enant improvement (remodel of Glacier Hall) I <br /> .. , d� I <br /> � I <br /> Prolect Address(il known) 801 WPf mnYF. � 'I <br /> Atlach lour(�1)wpies ol plens br proPosed work� Draw to scale and note the follow�ng as applica6le: � I <br /> • Properly Lines • CeNerline ol street ♦A i <br /> � • Outline and dimensions of all ezistinq and • Indicate Nor�h V� <br /> . pwposed stmctures on Ihe lot • Show any pr000sed grading changes '�, <br /> -- • Exislin�and pmposed utilities O Shrnv measurements � <br /> / � � <br /> C�� DO NOT WRIT[BELOW THIS LINE O <br /> � PERMIT CONDITIONS <br /> 1.All cslls for inspection shall be made 24 hrs.in adiance-phone 253•8610. � <br /> ._� 2.All work shall be pertormed in accordance wilh this permit and current City of Everett Design and Constmction <br /> I `� Standards end Specilicalions. <br /> 3.Coll Location Underground Service 48 hrs.belorz you dig.70LL FREE NUMBER 1-800•424•5555. � <br /> �� L-i O <br /> �v�ic,U�o��/-���Lc� /�at�,(Lnd cu,u� L <br /> ♦r^ ' <br /> i �� �� V+ <br /> ,,_,�3 -9i � <br /> � �-,_, a <br /> � <br /> � <br /> � ACKNOWLEDG[MENT OF CONDITIONS <br /> ��. <br /> The untlersigned owneUapplicant hereby a9rees Io hotd and save harm- <br /> less �he Cily of Evewtt fmm any and all claims tor dama9es, cos�s. <br /> ezpenses, or causes of action 'ha1 may arise because of ins�alla�ion <br /> 2nd maintenance ol �he impr.,, -, ent or other right�ol�way use hereto <br /> applieA lor and further agrer: w iemove same upon notice irom Ihe <br /> Approved for Consiruction Date ���y�nd to replace public pn+perty Jamagetl ihereby. <br /> fINAL INSPECTION Date �II <br /> ApProved as Conslrucied Sic�nature ol Appticanl Date � <br /> ���� FUBLICWORKSCLPARTMENT WORK AUTHORIZED BV THIS PERMIT MUST 3E STARTED WITHIN . <br /> 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> J200CetlarStreet I BE DILIGENTLV PUFSUED TO COMPLETION.THIS PERMIT A1AY BE <br /> :verett,WA98207 CANCELLGD BV THE CITY UPON ANY STOPPAG[OF WORI<ON THIS <br /> '�i�ane:259-BB70 PROJECT OVER 90 DAVS DURATION. <br /> I <br /> I � <br />