Laserfiche WebLink
Date <br />Applicatlon For � <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Plan Check No: 8 43590 <br />Applicat.Date: 02/23/94 <br />Job Addrs: 1500 52ND ST 3L- <br />Owner: EVERETT GOLF 6 <br />Owner Tenant: <br />, Propoeed Use: LOCRER ROOM <br />Deac. of Work: <br />AEMODEL OF MEN'S LOCKER RM <br />Applitant <br />SEPA <br />COUNTRY CL <br />OFFICE SET JOB SET <br />Descr(be Proposed Wor APPRVD FOR PERMIT: DATE_/_�_ <br />ProjBct Address (if known) <br />PuElic Worka Parmll • <br />BIEO. Dapl � �_ <br />PUEhc Worka Fes <br />TaIN Faa S <br />Lau AppL Fae P�IE �i <br />B���nce Due f <br />Z�P Phone <br />Z�P Phone <br />Attach four (a� copies of plans (or proposed work - Draw to scale and note the following as applicabte: <br />• Property Linea <br />• Outl(na and dtmensions of all exiating and <br />proposed stroctwes on the lot <br />• Ez'.tfng and propoaed utllities <br />• Centerline of street <br />• tndicate North <br />• Show any proposed grading changes <br />• Show measurements <br />PERMIT CONDITIONS <br />1. All calls for fnspectlon ahall be meue 24 hra in advance • phone 259•8810. <br />2. All work ahall be peAormed in accordance wilh this permft and curtent City of f_verett Design and Conatruction <br />Standarda and Speciflcationa <br />3. Call Location Underground Service 48 hra before yau dig. TOLL FREE NUMI3ER 1•800-424-5555. <br />PUBLIC WORKS PERMIT <br />NOT REOUIRED <br />BY <br />DATE � � 9!� <br />� Approved for Canstruction <br />Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />���PUBLIG WORKS DEPARTMEN7 <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone:259•8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Eve�etl Irom any and all claims for damages. costs, <br />expenses, or causes ol action that may arise because of Installation <br />and maintenance of lhe improvemenl or other right-of•way use hereto <br />applied for and further agrees to remove same upon notice (rom the <br />City and to replace public property damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHOfiIZED BY TiiIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PEFiM1T MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPA6E OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATIOP� <br />