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��x <br />�H� <br />H�� <br />K � <br />� � � <br />CA M <br />�O� <br />OH <br />��g <br />QY (] <br />ry�H <br />� � <br />H <br />� y <br />�O� <br />� <br />� �� <br />Date— <br />� <br />Appli.:alion For <br />PUBLIC WORKS PERMIT <br />Print cr?Yce Only <br />Owner <br />Applicant <br />Plan Check No: <br />Applicat.�ate: <br />Job Addrees: <br />Owner: <br />Tenant: <br />Propoeed Uee: <br />Deac. of Work: <br />T,I. - 3370SF <br />H 39393 SEPA <br />O1/28/93 <br />9930 $VEAGP,EEN WY HLDG B <br />BOEING <br />OFFICE <br />� <br />Describa Proposed Work _ OFFICE SET J08 SET_� <br />APPROVED FOR PEFMIT: DATE_/_I� BY <br />Pud�ia M'orke Permit • -- <br />emp. oeo�. • <br />Public Workf Fee S --� <br />Talal Fao <br />LefaADO� Fea PaiO S �------ <br />Ba�ance Oue $ ��— <br />Phone <br />, Phone <br />Project Address (il known) - -� <br />Atlach four (4) copies ot O�ans lor proposed work - Draw to scale and nole mc lollowing as applicable: <br />• Property Lines <br />• Outl�ne and dimensions of all existing and <br />proposed struc[ures on �he �ot <br />• Ezisting and proposed utilil�es <br />_ :.��i <br />• Centedine ol street <br />• Inditate Norih <br />• Shew any proposed yradir ; changes <br />• Show measurements <br />PERMIT CON�ITIONS <br />7. All calis tor inspection shall be mede 24 hrs. in advance • Phone 259•8810. <br />2. All work shall 6e pedorrned in accordance wilh this permil and currenl City ol Everelt Design and Construction <br />St�ndards end Specilications. <br />3. Calt Location U�deraround Service 48 hrs. betore you dig. TOLL FREE NUMBER 1•800•424•555 . <br />PUBLIC WORKS PERMIT <br />NOT REQUIRED <br />DY �� <br />DATE Z���l� <br />Approved for Ccnstruction ���e <br />FINAL INSPECTION Date <br />,qpproved as Construcled <br />�ArI�� PUBLIC WOPKS DEPARTMENT <br />3200 Cedar �Ireet <br />EveretC WA 98201 <br />P�ione: 259�8810 <br />W <br />� <br />�wa <br />_ / <br />Z <br />O <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owneuap0licant hereby agrees to hold and save harm� <br />less Ihe Gity ol Everec Irom any and all claims lor damages, cosis, <br />expenses, or causes of action that may arise 6ewu:e of instsllation <br />and maintenance ol lhe improvement or other righl�ol�way use herato <br />applied lor and �onh2r agrees to remove eame upon notice Irom the <br />Ciry and te replace public property damaged thereby. <br />Dale <br />Signature of ApPlicant <br />80�DAY5 OFRDATED PERMIT ISEISSUED ANDB HER AFTER ISHTO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF VJORK 7N THIS <br />PROJECT OVFR 90 CAYS DURATION. <br />