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�F� � <br />�-:: <br />� ��������� <br />F <br />Owner Name: 'J ��i� t" Cu�•�� � ��� �� <br />�- <br />Mailing Address: �� �� ��, <br />� �G t � �ji � V � Ll �j ��� \ <br />Email Address: <br />Phone Number: <br />Contact for Permit (Name/Phone/Email): <br />Application for <br />Public Works Permit <br />Public Works Department <br />3200 Cedar Street <br />Everett, WA 98201 425-257-8810 <br />Date: � � /� �� �� 3 <br />Applicant Name: T��' ��tL �, , �� <br />Mailing Address: / v l � � ��(�, ��F= .� � <br />� `�G C �. �y� � �< <�c �' L <br />Email Address: <br />Phone Number: ���� `���-{ � � (i �� <br />Description of Work: �Cvr� �' � �i � �V� <br />(A drawing or plans may be needed to illustrate work to be done) <br />r� <br />Site Address: � �� � i `�� <br />Comments from Inspector duri <br />initial inspection: <br />Approved for issuance by: Date: <br />