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A��L����"I�P� ��r <br />����,.�� ���l�� ���.��7' <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 425 4 257-8f310 <br />Owner Name: �.,, t��" `<'!'i.t,tv-�'- �`��4''�- Applicant Nome: <br />G� � <br />Mailing Address: ��� � � � c�-1,�7 {„Q, �j i�. �, � Mailing Address; <br />--r� <br />'� u�� ��� �. � .; � �� <br />Phone Number: -�-- <br />Description of V�lork: <br />Site Address: <br />Phone Number; <br />-�. ,.�' -�"�.:-�'� C..�t. �%.'�[. L� � n, <br />1+�� C�G,..� d. 1A ��-#�, 1J.�.. <br />(n drawing or <br />.! <br />� �o�_ � <br />} � S/�l/ 'r � t.% ,^ - � i � � <br />Date ,� � �j � Z <br />� "C�` `r <br />�!(.� � �� l ��`�� 5T' <br />��I�'t.a�. , LJ � - <br />�..2�� ��a -5ov�e <br />� <br />� , <br />4 c..t.. <br />may be needed fio illustrate work to be don�:) <br />� �"-f—` <br />Comments from Inspector during initial inspection: <br />�� <br />Approved for issvance by: Date: <br />