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Date__ <br /> Appbrs nun For P0j D.ot e <br /> PUBLIC WORKS PERMIT ~'�•°^x'" <br /> opal Fr { <br /> I.fool 1'.pi{ <br /> a.4K.Du. { <br /> Print or Type Only <br /> Flee Check No: B 276J3 <br /> 'VJ11CAt.Dete, 09 04//91 <br /> Ownor ob Address, 1476 90TH ST SN SUITE O Ln Phone <br /> Sepal Number, <br /> Ocners EVERETT 576 LOT PARTNERS <br /> Proposed Leal COMMERCIAL <br /> p(1es. of Work, Z,c Phone <br /> Applicant T1 — OFFICE/WIISE <br /> Describe Proposal Wor OFFICE SET _JOB SET_ — <br /> ___ APPROVED FOR PERMIT, DATE_/_/_ By_____ <br /> u <br /> Project Address III known) _ I- <br /> Attach lour(4)copies of pians for proposed work•Draw to auto and note the fallowing as appligble: m <br /> •Properly Lines •Centerline of street /. <br /> •Outline and dimensions of all existing and •Indicate Northv <br /> proposed structures on the lot •Show any proposal grading changes <br /> •Existing and proposed utilities •Show measurements a <br /> DO NOT WRITE BELOW THIS LINE C <br /> PERMIT CONDITIONS <br /> 1.At calls lot Inspection shell be made.4 him In advance•phone 259.8810. m <br /> 7.All work shall be performed In accordance with this permit and current City of Everett Design and Construction <br /> Standards and Specifitallone <br /> 3,Call Lccalion Underground Service 48 him before you dig TOLL FREE NUMBER 1.800.424.5555. <br /> Ild <br /> 91s•Yi C <br /> 0 <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned ownerilapplioant hereby sprees to hold and save here <br /> lose the City of Evo:etl from any and all coiling for damages, cost: <br /> lapenses.or ceusos of action that may arise because of insatiate <br /> and maintenance 1 the Improvement or other right-of-way use hotel <br /> applied for and ludher agrees to remove same upon notice from Ih <br /> Approved lot Consiruction Dale City and to replica public property damaged thereby. <br /> FINAL INSPEC(ION Dale <br /> Approved no Constructed Signature of Applicant Dale <br /> PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIr <br /> d7DU Cedar 81roe1 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS T( <br /> 320DC de 8 tree BE DILIGENTLY PURSUED TO COMFI ETION.THIS PERMIT MAY B, <br /> EverePhone: WA 0810 CANCELLED BY THE CITY UPON ANN STOPPAGE OF WORK ON THI: <br /> PROJECT OVER 90 DAYS DURATION. <br />