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Date <br />Application For ewPUBLIC <br />LW0Fk6P@lrm,. <br />WORKS PERMIT Works <br />W FeeFee001 <br />Fee PendPrint or Type Only <br />.o e S <br />Plan Check No: B 46201 SEPA <br />Applicat.Date: 11/14/9, <br />Job Address: 1520 OTH ST SW STE A <br />Owner: SLF MANAGEMENT <br />Owner — Tenant: ZUMIEZ <br />Proposed Ilse: OFFICE/WAREHOUSE Phone <br />Desc. of Work: <br />_ TENANT IMPROVEMENT <br />Applicant <br />OFFICE SLT__ JOB SET Phone <br />Dcscribe Proposed Work — APPROVED FOR PERMIT: DATE_/^ /_ By <br />W <br />Project Address (if known) <br />Attach lour (4) copies of plans for proposed work - Drae, to scale and note the following as applicable: <br />H <br />• Property Lines •Centerline of street <br />• Outline and dimensions of all existing and <br />w <br />• Indicate North <br />Proposed structures the lot • Show any proposed grading changes. • Existing and proposedd utilities <br />9 s <br />• Show measurements <br />DO NOT WP.ITE BELOW THIS LINE <br />PERMIT CONDITIONS <br />1. All calls for Inspection shall be made 24 hrs. In advance- phone 259.8810. <br />2. All work shall be performed In accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800.424.5555. <br />O <br />PUBLIC WORKS PERMIT <br />NOT REOUIRE• <br />4A �/ 9 9Y <br />RATE <br />O <br />a <br />Approved for Construction Dale <br />FINAL INSPECTION Date <br />Approved as Constructed <br />WORKS DEPARTMENT <br />CLPUBLIC <br />3200 Ceder Street <br />Everell. WA 98201 <br />Phone: 259.8810 <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, costs, <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 />City and to replace public properly damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />