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• 6/29/84 �Y w �, <br /> �8t8 o�erc work�Pumh• <br /> ApDllcatlon For Biay oao�.• 84/13568 <br /> PUBLIC WORKS PERMIT P���'�N'orR�Faa <br /> Tol�l Fsa s ��� �, <br /> Ln��ppL Faa P�iO s <br /> Print or Type Only 8.�.��.o�. s � • �° <br /> ����� <br /> Gene Fosheim P.O. Box 5234 Everett 98201 337-1317 <br /> Ow�er Mailinp AOdress City Zip Phone <br /> Gene Fosheim � <br /> �i <br /> Applicant Meiling ACdress City Zip Phone <br /> Construct four car garage with second story apartment � <br /> Deacribe Proposed Work _ <br /> — H '~+1 <br /> _ W H � <br /> � <br /> Pro�acl Address(if known) 2421 Rucker � � 4 <br /> Attach four(4)copies of plans for proposed work- Draw to scale and note the following as aoPlicable: � y � <br /> • Property Linee • Centerline ol slreet � � <br /> • Outlina end dimenaions of all existing and • Indicate NoAh � <br /> propoeed ntructures on the lot • Show any proposad grading changes <br /> • Existinp end proposed utilitiea • Show measurements � Z <br /> DO NOT WRITE BELOW THIS LINE � M <br /> � � <br /> PERMITCONDITIONS � <br /> 1. All calln for inapection shell be maCe 24 hrs. in advence- phone 259•8B�5. � � <br /> 2. All work ahell be partormed in eccordance with lhis permit and current City ol Everett Design and Construction � <br /> Stendard6 and Speciflcations. <br /> 3. Cell Locetion Underground Service 48 hrs.belore you dig.TOLL FREE NUMBER 1•BOO•42O•55$5. � N <br /> O � � <br /> � • � <br /> � � <br /> O M <br /> a N <br /> � <br /> M <br /> � <br /> ACKNOWLEDGEMENT UF CONDITIONS <br /> _ The undersigned owner/applicant hereby agrees to hold antl save harm� <br /> less Ihe City ol Everett from any and all r,laims for damages, costs, <br /> expenses, or causes of action that may arise because ol installation <br /> ���.�� ��,_�'� 7_Z . j y and mainlenancc of ihe improvement or other right�ol�way use hereto <br /> applied lor and furiher agrees to remove same upon notice Irom the <br /> Ap oved fm Construction Date City and to replace public properry damagetl thereby. <br /> ��T . �'l'�<,-r-y � � <br /> �INAL INSPECTION � D� a�e �'U' �� � �`�— �'—�� <br /> Approved es Consiructed Signature of Applicant �ate <br /> everett PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BV THIS PERMIT MUST BE STARTFD WITHIN <br /> � 3200 Ceder Sireel 180 DAVS OF DATE PERMIT IS ISSUED AND TNEREAFTER IS TO <br /> Everett,WA 98207 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE <br /> Phone:259-8815 CANCEILED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT UVER 50 DAVS DURATION. <br />