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b ation Fw <br />PUBLIC RKS PERMIT <br />TYPE OR PRINT ONLY <br />Owner <br />ApPilcant — <br />Describe Proposed Work _ <br />PROJECT ADDRESS (if known) <br />PUBLIC WORKS DEPARTMENT <br />3200 Cadar Street <br />Evxetl, WA d8201 259-BB10 <br />� <br />oe,e <br />Public Waks Permit N <br />BWlding Permri Y _ <br />Public Worke Fee S _ <br />Plan Chack No: 8 57479 SEPA <br />]1pp11cat.Dat�: 12/18/97 <br />Job F.9dreses 9930 kVERGRBEN Wl►Y <br />owners REAL PROPERTIES INVS4TORS <br />2ennnt: NW DIST ASSEMBLIES OP� ^-:.0 <br />Propoeed U�es ASSEHBI�Y <br />Deec. oi Works <br />TENANT SMPROVEMENT BLDG Y SUITE 100 <br />OFFICE SET JOB SET <br />APPROVED FOR PBRMITt DATS_/_/_ <br />Ptwne <br />attach tour (4) coples ot plans for proposed work - Draw ta scale and note the tollowing if appiicable: <br />•Proparty tlnas 'Outlfne and dimens�ons of all existing ar.d proposed structures on the lot •Existing and proposed utilities <br />•Centerline of street •Indicate NoAh •Show any pr�:posed grading chenges 'Show mcesurements <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 pertormed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specitications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />xua►.�s waeu� rca�lNr <br />T Ri�YMIi� <br />iY <br />�Af� iZ g � <br />Approved lor Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />ACKNOWLEOGEMENT OF CONDtTIONS <br />The undersigned ownedapplicant hereby agrees to hold and seve harmless <br />the City of Everott from any end all claims for damages, costs, expenses, w <br />causes ot action that may arise because of installation and meintenance of <br />the improvement or other right-ol-way use hereto epplied for and Iurther apraes <br />to remove same upon notice from t�e City and to replace public property <br />damaged thereby. <br />5lgnature of Appiiwnc <br />.4lRHORIZED BY 7HIS PERMIT MUST BE STARTEO WITHIN 180 DAYS OP OATE PERMR IS ISSUED AND THEREAFfER IS TO BE OILIGENTLY PURSUED TO <br />.Ef10N. THIS PERMIT MAl' BE CANCELLED BY THE CIN UPON ANY STOPPAGF OF WORK ON THI� PROJECT OVER 90 DAYS WRATION. <br />