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.-- <br />Date ^ <br />Application Fo� <br />PUBLlC WORKS PERMIT <br />Print or Type Only Plan Check No: C 42680 SEPA <br />Applicat.Date: 11�12/93 <br />3ob Addresa: 14 6 35TH ST <br />Owner: JOHNSON HOWARD DR <br />Tenant: <br />Owner Propoaed Uee: OFF?CE SPACE <br />Desc. of Work: <br />OFFICE ADDITIQN <br />Applicant <br />Describe Proposed Work <br />Project Address (if known) <br />P�Olie Work� Permtl • <br />Bltlp. Dapt � _ <br />Public WorMa Fe� <br />To�al Fee = <br />LesaAppL Fes PaIE .S <br />Ba7ance Uue f <br />�. <br />Z'P Phone <br />OFFICE SET. JOB SET <br />Z�p Phone <br />APYROVED FOR PERMIT: DATE_�_�_ gy__ <br />Attach four (4) copies ol plans for pioposed work • Draw to scale and note the following as applicable: <br />0 ProFerty Lines <br />• Outli,ie and dimensions of all existing and <br />proposed strucWres on the lot <br />• Existing and proposed utilities <br />• Centerline of street <br />• Indicate North <br />• Show any proposed grading cha�iges <br />� Show measuremenls <br />PERMITCONDITIONS <br />1. All calls for inspection shall be mede 24 hrs. in advence - phone 259-881 O. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and Constructlon <br />Standards and Specfficationa <br />3. Call Location Underground Service 48 hre. be(ore you dig. TOLL FREE NUMBER 1•800-424•5555. <br />PUBLIC WOqKS PERMIT <br />NOT REOUIRED <br />BY � <br />DATE // /S 3 <br />. Approved lor Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Ceder Street <br />Everett WA 98201 <br />Phone: 259•8870 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />� <br />� <br />� <br />� <br />� <br />� <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm• <br />less the City of Everett from any and all clafms for damages, costs, <br />expenses, or causes of action tl�at may arise because of installation <br />and maintenance of the improvement or ather right-ol-way use hereto <br />applied lor and turther agrees to remove same upon notice from the <br />City and to repiace public property damaged thereby. <br />Sigrature of Applicant Date <br />WOR� AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />780 DA;'S OF DATE PERMIT IS ISSUED AND THEREAFTER IS 70 <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERI,IIT MAY BE <br />CANCELLED 8Y THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECi OVER 90 DAYS DURATION. <br />