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Date <br />qpplication For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Owner <br />Applicant <br />Plan Check No: B 44170 <br />SEPA <br />Applicat.Date: 04/21/94 <br />Job Addresa: 1001 N BROADWAY <br />Teaieit: ALTRONICSLIAM <br />PYopoaed Uee: PARKING <br />Deac. of Work: <br />7205F POST FRAME BLDG <br />JOB SET <br />Describe Proposed Work � OFFICE SET� <br />— APPROVED FOR PERMIT: DATE_I��— <br />VUEIic Wo�ks Permu � �� <br />BIEq.OeCt. • <br />PuO��c Wark� Fee S — <br />Tolal Fee <br />Less AG��. Fee Pa�tl 5�� <br />BNance D�e g —�— <br />Phone <br />Phone <br />Proiecl Address (it known) licable: <br />Attach four (4) copies ol plans lor proposed work • Draw to scale and �o�e � Ce�l�eWine ol stP et <br />� property Lines • Indicate Norih <br />• Outline and dimensions ot ell exisling and � Show any Proposed grading changes <br />proposed slruclures on Ihe lot • Show measurements <br />• Existing and proposed utilities <br />__ ,.,,r,.,o�rc aci nw THIS LINE <br />PERMIT CONDITIONS hone 259•SS70. <br />t. All calls for inspeclfon shall be made 24 �•�rs. in advanco • p <br />2. All work shail be performed in accordsnce with lhis permit and currenl CiIY ol Everett Design and Construcl on <br />Standards and Specificatlons. <br />3. Call Localion Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800'424•555 . <br />�UBNOTWREOUIRED M�T <br />4Y � 2 i <br />DATE <br />Date <br />Approved lor Construclion <br />Dale <br />FINAL INSPECTION <br />Approved as Conslructed <br />����R� PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everet6 WA 90201 <br />Phone�259'BR10 <br />� <br />O <br />� <br />� <br />O <br />a <br />ACY,NOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees lo hold and save harm• <br />less Ihe Ciry of Everett from any and all claims for damages, costs, <br />expenses, or causes of aclion Ihat may arise because of installalion <br />and mainlenance ol the improvemenl or other righFof�way use hereto <br />applied lor and turther agrees to remove same upon notice from the <br />Cily and to replace public property damaged thereby. <br />Dale <br />Signalur ant <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED W�THIN <br />180 DAYS OF DATE PERMIT IS ISSUED 4ND THEREAFTER IS TO <br />CANCELLED BY THE C TY U ON�ANY STOPPAGEIOF VORK ON THIS <br />.,i,n irrr n�rrn nn nnVS f��'^�TInN <br />