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Date 4-22.-92 <br />Application For <br />PUBLIC WORKS PERMIT <br />1 <br />Print or Type Only <br />n,er<wm.. n,mn. 1 /SO <br />36465 <br />eusicwon.F.. s <br />mn F. <br />Let. AW fix, P.l f <br />B.Ym a.. <br />p�Y-.;zzvc/ram / <br />Robbins, Hook 6 Whitener 2925 Lombard Ave Everett 98201 339-5537 <br />Owner Meiling Address City lip Phone <br />Jere Whitener <br />Applicnnl Meiling Address <br />Describe Proposed Work change of use from SFR to law office with parking lot <br />339-5537 <br />W <br />Project Address (il known) 3501 Rucker Ave <br />Attach lour (A) copies of plans for proposed work - Draw to scale and note the following as applicable: <br />• Property Lines • Carl of street /A <br />• Outline and dimensions of all existing and • Indicate North v+ <br />proposed structures on the lot • Show any proposed grading changes <br />• Existing and proposed utilities • Show measurements <br />00 NO7 WRITE BELOW THIS LINE O <br />PERMIT CONDITIONS <br />1. All calla for Inspection shall In ccor an a it advance r panne 259•8870. <br />2. All work shall be performed In accordance with This permit and current City of Everett Design and Construction <br />Standards and Specilitations. <br />3. Call Location Underground Service JB hrs, before you d,, TOLL FREE NUMBER 1-800.424.5555. <br />7'I / AJ�_1r7- �`,QN. 4e, air,. .4/ fir- 'F� O <br />.S LC/J4,r .Smear-tv,� gn".-f d l <br />_e� or.J �i .20 all <br />�, C�i:.al -� Q �u�u(a riv oovQ�eti .(.� ..fiC� S'eaPe• Sewte�. r Cl) <br />ae <br />I_ 1. o^ sr t SPtA <br />PST ten Weft-ci°" <br />nn <br />a wrr�— <br />1/P (1t-t vv\ o ACKNOWLEDGEMENT OF CONDITIONS i ris,5. <br />J The undersigned owner/applicant hereby agrees to ho d and Savo farm. <br />less the City of Everett from any and all claims for damages costs <br />expenses, n causes of action That may arise because of use hereto <br />an mXnlenanca of the improvement or other lighPo4way use hereto <br />applied or and to Cher agrees "move <br />same upon notice from the <br />pppif d 1 C nslru on a Date City and to r1epuhc public ph.p y amaged thereby. <br />el HA PECTION Date A —26 ` /2— <br />kpproved as Constructed Sugnhunj of Appllc ut Date <br />PUBLIC WORKS DEPARTMENT WORK A THORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />INI180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />32000edar Street <br />Everett WA 98201 ON BE DILIGENTLY PURSUED TO OOMPLETION. THIS PERMIT MAY BE <br />Panne, WA 8610 CANCELLED BY THE CITY UPANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />