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w.v't�:+ � �t�' . <br /> �:wY,aY.-�.ei.�4'_� 4 <br /> . ���' ,C�Y .. <br /> � Pu�hc WarN�Parmn. <br /> �ate Z/25/91 —- <br /> e�ae oem.�—91/2G535--- -------- <br /> Application Fcr <br /> PUBLIC WORKS PERMIT °°°'"•:°,�„P8 <br /> Tolai�ee S— <br /> y �H �esaaoo�.�ee va�a 5 <br /> ��� Balancn Due S <br /> p a� Print or Type Only <br /> �1 <br /> 9Ht~i� <br /> H �� Ted Brose 2530 Mountain View F�rl Pt Orchard. WA 98366 871-4547 <br /> � � Owner Mailing Address Gity 2ip Phone <br /> H 71 <br /> '�L H � North Sound hose 6 Fittinqs (tenant) <br /> y y ~ Applieant Mailing Address - Cdy Lp Phone <br /> � O� <br /> y d Tenant Improvement <br /> O H Describe Proposed Work <br /> H � g - <br /> �. � <br /> � y� - i.l.� <br /> g y H Nrcject Adtlress(il known) 3516 Paine ST H <br /> C�l7N <br /> Attach lour(4)copies of plans lor proposed work-Uraw to scalr and note the lollowing as applicat�ie: � <br /> �j� � • Property Lines • Centedine of street ♦^ <br /> Z H p� • Outline and dimensions ol all eaisling and • Indicate North V� <br /> y �y proposed slructures on Ihe�ot • Show any propased gratlmy changes <br /> � • Ezisting and proUosed ulilitirs • SLow measuremeNs w/� <br /> DO NOT WRITE BELOW THIS LINE � <br /> � PERMIT CONDITIONS <br /> 1.All calls 1or inspection shall be made 24 hrs.in advance�phone 259•8870. � <br /> ' '�! 2.All work shall be pertormed in accordance with this permit and wrrent City of Everett Design and Construclion <br /> �� Standards and Specilications. <br /> 3.Cali Location Underground Service 4B hrs.nelore you dig.TOLL FREE NUMBER 1•800•424•5555. w <br /> L <br /> . �_� O <br /> � ��� <br /> � �U� Gv�.� �-�°u�` ��a7� �'��ic�u:d' 1�' <br /> �� a � <br /> � ,-,1�� sr�� /' <br /> '/'I.� �� ,�7Cc !y O <br /> � 2, zs_ y, <br /> !1'i a <br /> i <br /> - <br /> � - <br /> � � ncr:raowi_�o��r,sr.�a� or coNoineras <br /> � <br /> The undersi9ned owneUappiicant heiel�y ayiees to hold and save haim� <br /> — less ihe City of Everett from any and all daims fo�� tlamages. r,osts. <br /> expenses, o� causes of aclion ihat may arise becausa ol inslallation <br /> and miintenance of the improvement or other ri9hPol�viay use hereto <br /> _ �pphr,�1 lor �nd fur�her a9rec� to removn ypine upon no�lcr� hom ihe <br /> Apl:'oved lor Gonslruc!ion Da�e Ci�Y�����o ie�ilace public pwp��ty tlama�ed �heie6Y_ <br /> FINAL IIJSP'G110tJ Daie ------ --"— - <br /> ApproveA as Conallu�ted 9ignatme ot Annhr.am D-e'e <br /> WOFK AUTHORIZEl7 6Y THIS PLRIJIIT MUST BE STARTED WITHIN <br /> evrrell PUBLICWORKSDEPFPTMENT 180 DAYS OF �ATE P�Rtd1T IS ISSUED AND TFiEFEAFTER IS TO <br /> � 3200 Cedar Stree� BE DILIGENTLY PURSUED 70 COIdPLETION. THIS PBRMIT IdAY �[ <br /> Evcren,WA 98301 CANCELIED UV tHF CITY UPON !d!V STOPPAGC nF 190RK OIJ TIiB <br /> Phone 259�Ba10 I�NOJCCT OVER 90 UAVS DUI3ATIOW <br />