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'C <br />C N <br />9 H !n <br />H�H-I <br />H�I <br />'d H <br />In H <br />z <br />H d <br />OH <br />08 <br />�• o <br />>Z>H <br />rHH <br />gCn <br />H <br />n Cb y <br />M 1 <br />ZF,E.0 <br />H O w <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />C ner <br />Applicant <br />Describe Proposed Work <br />Plan Check No: B 36522 SEPA <br />Applicat.Dates 04/27 92 <br />Job Addres 1420 BOTH ST SW BLDG A OF <br />owners EVERETT 526 LTD PTRNSP <br />Tenants P.P.O. <br />Proposed Uses COMMERCIAL <br />Deac. of Work: <br />TENANT IMPROVEMENT <br />Public Work$ Permit e <br />Bldg Dept e - <br />Pvbee Worlu Fee a <br />TMsl Fee <br />Lne Appt Fee PeW • <br />ee4me Doe • <br />OFFICE SET JOB SET _ <br />APPRVD FOR PERMIT: DATE_/__/_ By <br />Phone <br />Phone <br />Project Address (if known) -j <br />Attach four (4) copies of plans for proposed work • Draw to scale and note the lollowing as applicable: <br />�■ <br />/^ <br />• Property Lines • Centerllnd of street <br />• Outline and dimensions of all existing and • Indicate North <br />v, <br />proposed structures on the lot • Show any proposed grading changes <br />Is Existing and proposed utilities • Show measurements <br />M <br />DO NOT WRITE BELOW THIS LINE <br />O <br />C <br />PERMIT CONDITIONS <br />1. All calls for Inspection shall be made 24 hrs. in advance. phone 259.8810 <br />as") <br />i <br />2. All work shall be performed in accordance with this permit and current City of . ., rrtt Design and Construction <br />1 <br />Standards and Specifications. <br />3. Call Location Underground Service 48 fire. before you dig. TOLL FREE NUMBLA 1.800.424.5555. <br />z <br />ieft <br />O <br />U) <br />�B <br />0CL <br />1 (, <br />//- z7 =) c' <br />!li <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everett from any and all claims for damages, coals. <br />— —� expenses, or causes of action that may arise because of Installation <br />and maintenance of the improvement or other right-of-way use hereto <br />applied for and further agrees to remove same upon notice from the <br />Approved for Construction Dale City and to replace public property damaged thereby. <br />FINAL INSPECTION Date <br />Approved as Constructed Signature of A, plicanl Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WI <br />PUBLIC WORKS DEPARTMENT <br />180 DAYS OF DATE PERMIT IS ISSUED AND THE4EAF1ER ISS TO TO <br />3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />Everett WA 9e201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />Phone: 259-8810 PROJECT OVER 90 DAYS DURATION. <br />