Laserfiche WebLink
��rY��� ApplMatbn For <br /> PUBLIC Y )RKS PERMIT Date <br /> PUBLIC WORKS DEPARTMENT Public Works Pertnit p <br /> 3200 Cedar Street <br /> Everett,WA 98201 259•8810 Building Permit 8 •� <br /> TYPE OR PRINT ONLY Public Works Fee$ <br /> Plan Check No: B 5L1135 <br /> SEPA <br /> Owner Maiii APP�obCAddrese: 10730 19TSTATIONEINCTE D Phone <br /> Tenant: SOBWAY� . <br /> Applicant Maili Proposed Ueet RESTAORAfIT Phone <br /> Desc. of Work: <br /> T.I• <br /> Describe Proposed Work Joe sE'r W <br /> OFFICE SET�— � <br /> pPPROVED FOR PERMIT� �ATE�/��� BY <br /> � <br /> N <br /> PROJECT ADDRESS(if known) M <br /> Attach four(4)copies of plans for proposed work-Draw to scale and note the following H applicable: . w+ � <br /> •Property IJnes 'Oulline and dimenslons ot all existing and proposed structures on the �t •Existing and proposed utilHles O <br /> 'Conterline ot sheet •Indicate North 5how any proposed�rad!ng chenges 'Show measurements � <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 2:i9-8810. O <br /> 2.All work shall be performed in accordance with this permit and curcent City of Everett Dasign and <br /> Construction Standards and Speciflcations. <br /> 3. Call Lxation Unde�ground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. H <br /> V♦ <br /> O <br /> nUB��0.� REOl11RE RM�• � <br /> �Y�/�, <br /> NATE.3L-`• u �G_,-- <br /> ( <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undereigned ownedapplicant hereby agrees to hold and save hertnless <br /> the City of Everett from any and all claims tor damages,costs,expenses,or <br /> causes ol acllon that may arise because of(nstallation and maintenance of <br /> ApprovedforConstruction Date theimprovementorotherright-ol-wayusehereloappliedforandturtheragrees <br /> to remove same upon notica from the City and to replace public propeAy <br /> damaged thereby. <br /> FINAL INSPECTION Date . <br /> Approved as Constructed <br /> Signature of Applicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE OILIGENTLY PURSUED TO <br /> COMPLEfION.THIS PERMIT MAY BE CANCELLEO BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />