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PUBLIC WO KR S PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 259-8810 <br />TYPE OR PRINT ONLY' <br />Plan Check No: <br />Applicat.Date: <br />Owner Job Addrs: <br />Owner: <br />Tenant: <br />Proposed Use: <br />sc. of <br />Applicant EQUIPMENTWSHEL <br />Public Works Permit 0 <br />Building Permit # <br />Public Works Fee <br />B 61709 SEPA <br />02//26 99 <br />9610 1 TH AVE BE <br />TRICONN NW <br />AIR TOUCH <br />EQUIPMENT BLDG <br />TER <br />Describe Proposed Work _ OFFICE SET_ JOB SET <br />APPRVD FOR PERMIT: DATE_/_/_ BY <br />PROJECT ADDRESS [if known) <br />Phone <br />Attach four (4) copies of plans for proposed work - Drew to scale and note the rollowinr, d applicable: <br />•Property Unes 'Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utiRles <br />eCentedine of street "indicate North 'Show any proposed grading changes 'Show measurements <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance -phone 259-8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5655. <br />°UDLIC WORKS feERMli <br />NOT�j R QUIREi� <br />EY___— - <br />OATfi_� ? <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />AM <br />C/ <br />ca <br />0 <br />z <br />0 <br />N <br />0 <br />a <br />ACKNOWLEDGEMENTOFCOMMONS <br />The undersigned ownerlapplicant hereby agrees to hoid and save harmless <br />the City of Everett from any and all claims for damages, costs, expenses, or <br />causes of action that may arise because of installation and maintenance of <br />the improvement orother right-of-way use hereto applied for and further agrees <br />to remove same upon notice from the City and to replace public PMP" <br />damaged thereby. <br />Signature cf Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WRHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER ISM BE DILIGENTLY PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION' <br />