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0!r <br />ApplkFor <br />Arff PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett. WA 98201 259-8810 <br />TYPE OR PRINT ONLY <br />Date 3-11-97 <br />Public Works Permit a <br />Building Permit # 54476 _ <br />7/_ <br />Public Works Fee $ �l'7 3tio % <br />Atlantic Richfield c/o Barghausen 13215 72nd Ave S Kent 98032 206-251-6222 Jay Grubb <br />Owner Mailing Address City Zip Phone <br />Applicant Mailing Address City Zip Phone <br />Describe Proposed Work <br />convenience store with <br />PROJECT ADDRESS (if known) ?oP31- <br />Attach four 4) copies of plans for proposed work - Draw to scale and note the following if applicable: <br />•Property Lines 'Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities <br />•Ccntedina 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 1-800-424-11 <br />y <br />�IrOved fA q tructtloonn Gate <br />FINAL INSPECTION Date <br />Approved as Constructed <br />05/21/97 1:34PM <br />/ <br />N00054476 <br />BLDB $834.48 <br />SRCIR6 $4.50 <br />#00097141 <br />OTHER $104.63 <br />PW/REV $77.67 <br />PW/DIS $485.41 <br />WOW381 <br />WATER $750.00 <br />1111101011109380 <br />WATER $1200.00 <br />W <br />H <br />0 <br />ca <br />O <br />z <br />O <br />U) <br />F IS <br />N00031106 <br />ACKNOWLED4011111IT OF CWIIMNS <br />The undersigned owner/applica@YN j allrMhtad and save harmless <br />the City of Everett from any an s f ,costs, expenses, or <br />causes of action that may ease o 1 and maintenance of <br />the Improvement or other right- for and further agrees <br />to remove same upon notice from the City and to replace public property <br />damaged thereby. <br />6 2/ % <br />Si re plicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERM IS I UED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br />'OMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />