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� / <br /> �/ APPlication For 2-2-96 , <br /> PUBLIC WORKS PERMIT Date <br /> PUBLIC WORKS DEPARTMENT Publir.Works Pertnit# JY OBD <br /> 3200 Cedar Street <br /> Everett,WA 98201 259-8810 Building Pertnil# 50782 __ <br /> �,. �1� /liie Q.,` 70 <br /> i� Q�° Public Works Fee$ �Z � / b� — <br /> TYPE OR PRINT ONLY l l '2���¢ --7 <br /> 7 <br /> I Richard Johnson 9502 19th Ave SE Suite C Everett WA 98208 <br /> Owner Mailing Address City 7ip Phone <br /> BoteAch, Nash & Hall Devin Saylor or Jeff Moore 259-0868 <br />', Applicant Mailir��.Address Ciry Zip Phone <br /> pescribe Proposed Work office bldg for Washington Eederal Savings � <br />, � <br /> � ��/� <br /> f-���=/9'uAve. J'E o�iaei3� a.z��•n 000an�:,:� `!�<.:� <br /> PROJECT ADDRESS(if known) M <br />� �000so�e� ■++ <br /> Atlach four(4)copies oi plans for proposed work-Draw to scale and note the following if applicable: y� g�15?..90 O <br />� 'Property Lines �Outline and dimensions of all existing and proposed structures nn the lot •Existing and pr� utilitl8'S'�4.5J <br />�I �Centedine of streel •Indicate North •Show any proposed grading changes •Show measurements b000T0521 ' <br /> DO NOT WRITE BELOW THIS LINE ' " '� <br /> PERMIT C:ONDITIONS: N00096080 � <br /> 1.All calls for inspection shaii be made 24 hours in advance-phone 259-8810. �T`=� �50.00 <br /> 2.All work shall be performed in accordar�ce with this permit and current City of Eu�f�k�Desi�h�ar+�' � <br />� Construction Standards and Specifica'ions Fu/:(��: "�7"'� <br />� 3. Call Location Unc+arground Service 48 hrs. befere you dig. TOLL FREE NUMB�I�1-800�5• H <br />'' � CRECt: 47.3689.'_� <br />� � o1�LC.ei WOZ� � BG> G3'o%'IC P�r a�oprv�c�� \II <br /> �CQh c��¢� 3-- r-96 ���/ ��clec� � <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned ownedapplicant hereby agrees to hold and save harml=ss <br /> 3 7 the City of Everetl from any and all claims for damages,costs,expenses,or <br /> l�-� causes of action lhat may arise beceuse of installation and maintanance of <br /> Ap v or onstructi� Dat lheimprovementorotherright-of-wayuseheretoappliedforandfurtheragrees <br /> '� to remove s�me upon notice from the City and to replace public propedy <br /> � __�.� /�� � damaged!hereby. <br /> C � Date <br /> v as Constructed — <br /> Q_ <br /> i aWreofAp I' ant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DAT RMIT IS ISSUED AND THER:AFTER IS TO E DILIGENTLY PURSUED TO <br /> COMPLEfION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />