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� z� ,� <br />= 3 <br />sY .0 �Y' <br />�. : :: f{� ETT <br />���-- <br />APPLICATION for <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 425 -- 257-8810 <br />Date /� �jZ._ <br />Owner Name: C� r�'��LC'v-C_� �rC�ir�f �r �, LLC� Applicant Name: �%P'�u i��Ch.'- �rc��'�'Yf i��'� L-L �. <br />Mailing Address: ���-�� /iL��S�CLi) f�(,,�' . Mailing Address: �����"����� �- ✓��� <br />�t !O(��t' u��' �i . l�/� . �b'L�nrC) <br />Phone Number: <br />Description of Work: <br />Phone Number: <br />/4 /! �/1'� fZ�ii, �L ��� �8v�:� � <br />3G�.• ��5�2- 9�,z7 <br />''�',��'� ��'� �c'u.%� y !'�'�r'�' �'�'�. �'�� �' �`y_S b� � J <br />� <br />.� �� � fir ��' /1 �' �-� �' c4 r,[� �>�:��, ��' `-�'i � � S��C L� i�l���i�irz ��S <br />• � '� <br />(A drawing or plans may be needed to illustrate work to be done) <br />• <br />Site Address: �lo/ �v'c�r jr' �E��l ZL�I� �i, � 1/�r�L� , ���% . �"��L�`� <br />Comments from Inspector during initial ens�.= <br />Approved for issuance by: Date: <br />