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�, <br /> r.... <br /> Date ���n���wo,w,ae,mu. _ <br /> Appiicalion For omo�000�.• <br /> PUBLIC WORKS PERMIT Pu�1�tWorkaFee -- <br /> Tolnl Fee 5_ <br /> Plan Check No: B 45644 <br /> SEPA �ua�oot Fee vud 5 <br /> Print or Type Only Apglicat.Date: 09/22/94 e.�.��eo�4 s <br /> Job Addreee: 10730 19TH AVE SE <br /> Owner: SUN TAi INC <br /> Tenant: 19TH ST STATION . <br /> Propoeed Uee: RESTAttRANT . <br /> Deec. of Work: _ <br /> OwnBr TI Zip PhOne <br /> OFFICE SET JOB SET <br /> Appli�ant APPROVED FOR PERMIT: DATE_/_/_ BY Zip Phone <br /> Describe Proposed worl � <br /> � ------------ I� . <br /> Project Address(if knownl . L <br /> I� <br /> 4ttach four(4)copies ol plans lor propoSeJ wurk • Drnk• lo Sr.al�:and ncte the loilcwing as applicable.: �� <br /> • Property Lines • Centerline of slreel ♦A <br /> • Outline and dimensions ol all existing and • Indicate North V� <br /> proposed structures on the lot • Show any,r,roposed grading changes <br /> • Existlng and proposed utilities • Show measurements � �. <br /> , ; DO NOT WRITE BELOW THIS LINE O �. <br /> PERMIT CONDITIONS <br /> 1.All calls tor inspection shall be made 24 hrs.in advance•phone 259•8810. � <br /> 2.All work shal�be peAormed In accordance with this permit and current City of Everett Design and Constructlon <br /> �. Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.betcre you dig.TOLL FREE NUMBER 1-800•424•5555. � - . <br /> � <br /> H � <br /> �// . :� � . ... ;:� <br /> PUDI.10 wpRKB PERp11T O I <br /> N07 REOUIRED �:� � <br /> ]Y 8 a ; � <br /> i/ATE�2 �% � �d <br /> ACKNOWIEDGEMENT OF COND�TIONS <br /> � The undersigned owner/applicznt hereby agrees to hold and save harm• <br /> -j less Ihe Cily ol Everett Irom any and all claims tor damages. cosls. <br /> � expenses. or causes of action that may�arise because ol ins�a�lation <br /> � � and maintenance of the improvement or other righl-of•way use hereto <br /> appi�eC lor and lurther agrees to remove same upan notice from the <br /> proved(or Construction Dale � Ci!y and b replace public property damaged thereby. <br /> i <br /> !AL INSPECTION ' D:.te <br /> �roved as Constructed Signature ol Applicanl Da1e <br /> WORK AUTHORIZED BY THIS PFRMIT MUST BE STARTED WI7HIN <br /> PUBIIC WORKS DEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 CedarStreet ' BE DIL�GENTLY PURSUED TO COMPLETION.THIS PERMIT �AAY BE <br /> Everelt.WA 98207 I CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259•8870 PROJECT OVER 90 DAYS DURATION. <br />