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� ~oPlication For .–. — <br /> PUBLIC ��ORKS PERMIT Da�, <br /> PUBLIC WORKS DEPARTMENT Public Works Pertnit M <br /> 3200 Cedar Stree� <br /> Everett,'NA 98201 259-8010 <br /> Building Pertnit M <br /> TY?E OR PRINT ONLY <br /> Public Works Fee E <br /> Plpan Check No: H 5/255/5 SEPA <br /> APJobCAddreaee BOI1WETHORE AVE <br /> �'^� Owner: EVERETT CC <br /> Tenant: OLYMPUS Hpyy Phone <br /> Propoeed Uae: COLLEGE <br /> Deec. of Work: <br /> �P�i��t FLOORFICURATION OF OFFICE SPACE ON 2ND Phone <br /> DBSC�be Propas9d V�brk� ��FICE S&T JOB SET <br /> APpROVED FOR PERMIT: DATE_�_�_ gY W <br /> � <br /> PROJECT ADDRESS(if known) � <br /> Attach four(4)copies of plans fa proposed work-Drew to scale and note the following if applicable: m <br /> �P�Y Unes `Outline arM tlimensions of all existing and proposed structures on the lot �Existing antl proposed utilities O <br /> 'Centerline of streat Mndicate North �Show any proposed grading chanpes •Show measurements <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-8810. <br /> 2.All work shall be pertormed in accordance with this permit and current City of Everett Design and O <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br /> /�� <br /> V♦ <br /> ' "UNLIC WpRHS O <br /> �yOr 'ERM�•, � <br /> REpUlREp <br /> =Y_.��� _ <br /> �AT�_._ /9 <br /> - ��_. <br /> ACY.NC'NLEDGEMENT OF CONDITIONS <br /> The undersiqned owneu�applicent hertby agrees to hold and save harmless <br /> the City of Everett from a iy and all claims for damages,costs,expenses,or <br /> Approved lor Consiruction Date causes ol action that mn�arise berause of installation and maintenanca of <br /> the improvement or othtr rigl:t-of-e•��;:s?hereto applieC}or and lurther agmes <br /> to remove same upoi: ^�::;,e trom the C�ty and to replace public property <br /> damaged ihereby. <br /> FINAL INSPECTION Date <br /> Approvetl as Constructed <br /> Signature of Applicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 OAYS OF DAiE PERMIT IS ISSUED AND iHEREAFTER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLEZION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WURK ON THIS PROJECT OVER 90 DAYS DURATION, <br />