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Owner Name: ��� <br />�1PPLICATION for <br />PUBLIC WORKS PEFtNIIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Sireet <br />Everett, WA 98201 425 --� 257-8810 <br />�`� �' �i �'� � Applicant Name: <br />Mailing Address: � 1 �������� ('. S�. Mailing Address <br />�� e��ce �'� C,'�c�. ��2G� <br />Date 1 %-5 IZ <br />_S'io:�i I��� r T�`nr� <br />l � I i`� ���"`' u;•� s� � <br />�v�re� f � ln,�; 9�to8 <br />u� <br />Phone Number. c�. 2�_"3 g� -$ U�4 Z Phone Number: _��,,,,,,� <br />ce� 2 c� � - �7 % `� � `� ��`' � <br />Description of Work: <br />(A drawing or plans may be needed to illustrate work to be done) <br />Site Address: � i �% I�_c� 6� c,.� o�' c� � O 1� � <br />Comments from Inspector during initial inspection: <br />��' �� � =/ � �� �� `� � � 5 � , <br />L`� — — —' <br />� <br />.�� <br />_ ,d �� ' `' - � � � [ <br />r"y g.,,�,... r ,.�-�,y - �. 9 ��.., �.�i ;`} �j <br />Approved for issuance by: Date: <br />