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Appli�a$ion ��� <br />Publi� V!/orks Per�i� <br />Public Works Department <br />3200 Cedar Street <br />Everett, WA 98201 425-257-8810 <br />Date: �C� �Z- � �� �� <br />Owner Name: ��O �l� ����L��I��rll Applicant Name: 5���� � <br />MailingAddress: 5 ��� IZ � 5� I��-��-MailingAddress: <br />% ,Q-i�•� �,-�-�v� , �v'� ��2�:� <br />Email Address: � c�i�r�: ic�t��� ��<�t �-d�i-i�-�%',��_ .i��r�i <br />Email Address: S/l�N� <br />Phone Number:� ���/3L l�'��% �-5 <br />Coniact ror Permit (Name/Phane/Email); <br />Phone Number <br />Description of Work: ���-� l�j�"77.�-��-1v Vv�S7— ���'�� ��n���:�'� <br />/-IN�� �v�Y� , � � l� � � ; �U��� r'�'z S�-��`i'. <br />'l—_�; j;� �,r'i,s� U�_' r-�-iti-'C� �`� <br />(A drawingor plans may be needed to illustrate work to be done) <br />,I ,-__ <br />Site Address: ��,� L;� I:> j:o�-�i� l,t�;'��( i I�'c-= , C� v'�;")2_� <br />Comrnents from Inspector during initial inspection: <br />, � � ;, � � ��f-::. � i <br />',4 "� � <br />� ` ', � � �i ��� �� � j �', <br />� �� �� �s.� <br />.. s .' i <br />r <br />t��, ry . .- -_ <br />i � � <br />� � �, , <br />9 i^:`,{" ... , . <br />6� ` <br />Approved for issuance by: Date: <br />