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— PuEllc wod�Permll• <br /> Date <br /> Blep.Uaot.• <br /> hppiicatlon For <br /> �UBLIC WORKS PERMIT Pu01¢Wo�k�Fea <br /> Tot�l Fee S <br /> Lesa ADD�Fee P�iC S <br /> B�I�nca Oue S <br /> Print or Type Only � <br /> Plan Check No: B 44143 SEPA <br /> Appllcat.Data: 04/19 94 <br /> Job Addres 10012 ST DR SE <br /> Ownec: WASHINGTON MUTUAL <br /> Owner Tennnts Zip Phone <br /> Propoeed Uee: BANK <br /> Deec. of Work: <br /> ' ADDN 11ND TI <br /> Applicant Zip Phone <br /> OFFICS SET JOB SET <br /> Describe Proposed Work APPAVD FOR PERMIT: D71TE_/_/_ $Y <br /> W <br /> Prolect Address(it known) � <br /> Altach lour(4)copies of plans for proposed work- Draw to scale and note the fo�lowing as applicable: � <br /> • Property Lines • Centerline of street � <br /> • 7utline and dimensions of all existing and • Indicate Ncrth <br /> proposed structures on the lot • Show eny propose^grading changes , <br /> • Exisling [��d proposed uti�ities • Show measurements M <br /> W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS � <br /> 1.All calls for inspectlon shall be made 24 hrs.in advance•phone 259•881 O. <br /> 2.All work shall be performed in eccordance with ihis permit and current City of Everett Desiqn and Construction <br /> Slandards end Spacificalions. � <br /> 3.Call Location Underground Service 4B hrs.before you dig.TOLL FREE NUMBER 1•800•424•5555. <br /> O <br /> � <br /> � <br /> NUBLIC WORKS PERMIT O <br /> NOT REQUIRED <br /> BY 6 � <br /> DATE ZU � <br /> .�CKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/aDPlicant hereby agrees to hold and save harm• <br /> less Ihe Cily ol Everetl from any and all claims for damages, costs, <br /> ezpenses, or causes of action thal may arise beeause ol Inslallation <br /> and maintenance ol the improvement or other right�ohway use hereto <br /> applied for and further agrees lo remove same upon notice from the <br /> Approved for Construction Dale City and to replace public property damaged thereby. <br /> FINAL INSPECTION Date Date <br /> Approved as Constructed Signalure ol APPlicant <br /> � PUBLIC WORKS DEPARTMENT <br /> 80RDAYSTOFORDATE PERMIT ISEISSUED AND THEREAFTER ISHTO <br /> 3200Cedar5lreet BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everett,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:255�8810 PROJCCT OVER 90 DAYS DURATION. <br />