Laserfiche WebLink
s� r <br />�2� zi <br />av'%' <br />�j,�:�i`�5„> _ �,;�'Uf ec'i%' <br />i��':�L �. f - , . <br />Owner Name: <br />Mai(ing Acldress <br />A��L��,�i�Of� �Fo� <br />�I,��b,.�� NHi,Jfa/�.� B'��1°A.l.� <br />PUBLIC WORf<S DEpARTMENT <br />3200 Cedar Street <br />Everelt, WA 982.OJ. 425 �- 7_57-H810 <br />��''� S�.%.'l�'Ji� )FgtiC'i`� <br />__�7��— ���� �� ._ ��€� ���- <br />���t�a�f`t� t�i�! �`���1'� <br />—.�— <br />Applicant Name <br />Mailing �ddre;ss; <br />Date i �( <br />_ ��'�. �i; `�.��A�t�.$ <br />----f �.P.�_ %���_.�'� .__,���t.__ �'C� 4 <br />�sr��2�f�S . �iz ��z-��i <br />Phone Number; �p� ��� ���f� Phone Number, ���, ��;, ��� <br />f�escription of Work: {���pG�� ��i%��c^ �t1,����, pt�P QF�e,�t,�. L �6�5 <br />�ca c,�.r� r�v� (" �nr,�'i °�� ��� � � c�a� � � � � . <br />(A drawing or plans may be nceded to illustrate work to be done) <br />�; �j�e o�a y �r.� �'.��, muSG� <br />Site Address: �Q�� ��'�t�y /�l1�it�� , �1e�� i� t�� y� �.� � <br />� <br />Commenfs from Inspectar during ini�ial inspecfion: <br />Approved for issuance by: �__, __ I�aPe: <br />