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J - <br /> � PPlication For � <br /> PUBLIC ��ORKS PERMIT oate: 11-21-95 <br /> PUBLIC WORKS DEPARTMEM Public Works permit 8 <br /> 3200 Cedar Street <br /> Everett,WA 98201 259-8810 <br /> BuildingPermitN_ �-s-ni y <br /> IYPE OR PRINT ONLY � �1 PO STI N G AUG O 4 �Q�blic Works Fee S I <br /> Kellto 6 Molzan 3108 206th P1 SW Lynnwood WA 98036 774-5462 <br /> I Owner Mailing Address City Zip Phone <br /> Kirk 0'Flaherty 348-9171 Conar Coughlin 239-3571 <br /> Applicant Mailing qddress City Zi <br /> P Phone <br /> Describe Proposed Work convert to triplex (detached 3rd unit) <br /> W <br /> F- <br /> _ <br /> PROJECT ADDRESS(if known) 2217 Colby Ave � <br /> Attach four(4)copies of plans for proposed work-Draw to scale and note the following it applicable: m , <br /> •PropeAy Lines 'Outiine and dimensions o(all existing and p1oposed structures on the lot •Euisting and proposed utilities O <br /> �Centerline of street •Indicate North �Show any proposed grading changes •Show measurements <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-8810. <br /> 2.All work shail be pertormed in accordance with this permit and current City of Everett Design and O <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 7-800-424-5555. <br /> /�� <br /> V♦ <br /> � <br /> PUBLIC WORKS PERMIt • � <br /> hOT REOUTAEn �a /� Lik�. Q p�.(ic!<-�� 7� <br /> BV <br /> D' / <br /> pATE 1�i_9 s ' 79�� <br /> � 4 S�w�zr fJ¢.•r�if <br /> fo � .sa.�, e rr �-o��,-�y <br /> 4i��� %c- C�nneLfian-f <br />, ACKNOWLEDGEMENT OF CONDITIONS <br />, The undersigned owner/applicant hereby agrees to hold and save harmless <br /> ihe City of Everett trom any and all claims for damages,costs,expenses,or <br /> Approved for Construction pa1e causes ot action ihat may arlse because of installation and maintenance of <br /> the improvement or other right-of-way ese hereto applied lor and tunheragrees <br /> to remove same upon notice from the City and to replace public property <br />' damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed <br /> Signature of Applicant Da�e <br /> WORK AUTHORIZE�BY hIIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENttY PURSUED TO <br /> COMPLETION.THIS PERMIT MAY BE CANCELIED BY THE CITY UPOIJ ANY STOPPAGE C�WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />