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APPLICATION for <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 (425) 257-8810 <br />PUBLIC WORKS PERMIT REQUIRED? N 0 <br />�.8 <br />Date 01/19=1 <br />BLDG Permit No. B0101.016 <br />Owner: Mailing Address: <br />BRADLEY JEAN 1914 FAIRFAX AVE, EVERETT, WA,98203 <br />Description of Work: REPAIR FOUNDAITON (CHIP) <br />Site Address: 1914 FAIRFAX AVE <br />Legal Description: <br />Comments from Inspector during initial Inspection: <br />Approved tor !ssuance by: — Date <br />Phone: <br />4253530417 <br />