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� 5/23/85 ; ; ` L.�� �i�,/� � <br /> �8te Public Worka Permit• �r G�T <br /> eieo�oen+�s 85/14892 <br /> Application For � <br /> PUBLIC WORKS PERMIT PubllcWorkeFee <br /> Talal Fee S <br /> Lesa A00�Fee Paid S L� p <br /> Belance Due S Z�T zr/�O <br /> I Print or Type Only <br /> i <br /> i <br /> Suman Sethi P.O. Box 1713 ::verett 98206 252-9470 <br /> Owner Mei4ing Address City Zip Phone <br /> Same <br /> Applicant Mailing Address City Zip Phone <br /> Construct office building <br /> Describe Proposed Work <br /> W <br /> Project Address(if known) ��5/2-' �—'f vE -s � <br /> Attach four(4)copies of plans(or proposed work- Draw to scale and note the following as applicable: � ' � <br /> • Property Lines • Centerlire of street � <br /> � • Outline and dimensions of all ezisting and • Indicate North <br /> . proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements � <br /> � ' . DO NOT WqITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1. All calls tor inspection shali be made 24 hrs.in advance- phone 259•881 5. � <br /> 2. All work shall be performed in accordance with this permit and currer�t City of Everett Design and Construction <br /> Standards and Specifications <br /> 3. Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800-424•5555. � <br /> T. STE A�Io SY,eE'FT /mP.eovEincnJT fvo.e�-C To BE O <br />� laa,�.rE PE,e APP.eorEo P�a�vs DATEO 7-B-8s <br /> �/,S .�oP�icQ NT Ta P,eov�vE '�i6�9rs AS o{ Fo� � <br /> STiPEET IM/��0�'E�/ENTS A�1/� LANUS�.oP�NG-, <br /> ✓lo, APr'f/G,o.�l To AEE� /o't O� �.OW, �P O <br /> . To T.yF C�T}/ i'a� S7'�EET ��,evcsG-GS, a <br /> ACKNOWLEDGEMENT OF CONDITIONS I <br /> ' The undersigned owner/applicant hereby agrees to hold and save ha�m- <br /> less the Cily of Everett from any and all claims for damages, costs, <br /> - � expenses, or causes of action that may arise because of installetion <br /> c�" � r� � B �S and maintenance of the improvement or other right-of-way use hereto <br /> � Y�-�-� �%'� // applied for and further agrees to remove same upon notice from the <br /> App�oved for struclion Date City and to replace public property damaged thereby. <br /> �I <br /> 1�1 M�,�..�.a Iz-�z�s .- Q I <br /> FINAL INSPECTION Date �� � . <br /> Approved as Constructed Sig�a u;e of Applicant Date � <br /> everett PUBLIC WORKS DEPARiMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN �, <br /> � 3200 CedarStreet 180 DAYS OF D!tTE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Phone:259-8815 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 00 DAYS DURATION. <br />