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� <br />r;.; r��;.;. <br />`�� <br />,�'� > , <br />� <br />�"� �`��k�->�:'� •�"� <br />� ;: <br />� <br />r- <br />� ��� ( �L% �' _ �'�' � <br />Application for <br />Public Works Permit <br />Public Works Department <br />3200 Cedar Street <br />Everett, WA 98201 425-257-8810 <br />Date: ���2o rz, <br />Owner Name: 0�� ��; �c.r_ �/` �_ i'� t_. Applicant Name: _.-� �" ,t !' �- ;;; ���._.._ <br />Mailing Address: I t.n_ �r,- � ; r, , r- �v���-t Mailing Address: <br />�: *�:✓ t, <br />'� �` '- t ' � �'�.;�. '. %'. t.� "-N�-` �G�� <br />EmailAddress:szr��l�e fZ �o��ac�rME <br />.., <br />�� 3 <br />Phone Number: 2b��� �` '~ � �' t� <br />Email Address: <br />Phone Number: <br />Contact for Permit (Name/Phone/Email): ��<�'r-�� � �� ' r'" �= i �`%��t";` .`'j�.�,� � :=�'�, <br />Description of Work: �` - v��`�� «"'�� �='�" �''�' �� �-O/�,,3. <br />r�='�fp� �1, �"� ,� ' ., �.��'. I�1/�`i_ Q' �'�i r-oE;.�.l. '� � .�V; {_ � : � <br />,� � , , } , .�� , <br />(A drawing or plans may be needed to illustrate work to be done) <br />Site Address: ��'1 C'>'`.,,�,._�<_-, �-�,�� '� lfr=�?<- �� ` i�l� <br />> <br />Comments from Inspector during initial inspection: <br />Approved for issuance by: Date: <br />