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Owner Name: -ti2v<<r �• �L���:1�" <br />Application for <br />Public Works Permit <br />Public Works Department <br />3200 Cedar Street <br />Everett, WA 98201 425-257-8810 <br />Date: ca z-.��_ <br />Applicant Name: S��-�.�., ,� <br />Mailing Address: ��c� / /�o� � � -� ��.� Mailing Address: <br />C_ JitT,¢,e � i �/�"' /C� c: C7 � <br />Email Address: �9���-vc,, ���z�ss � �, , � • Email Address: _ <br />4-:..-� <br />Phone Number: �/Z:S -,��5--Z7`-/� <br />Contact for Permit (Name/Phone/Email): <br />Phone Number: <br />Description of Work: /—.z,,�c ,� i�., ��, y,r ; � .i' �J.��� �- <br />(A drawing or plans may be needed to illustrate work to be done) <br />Site Address: ��� / /���.� �.- �'� - <br />Comments from Inspector during initial inspection: <br />Approved for issuance by: <br />�� � � Ls � �% � ._.� <br />! ! 1 A�R � n if31d <br />+Gl�fY C��= ��'��ET 9 <br />I������it ���r�ic.;�5 <br />_,�..��, <br />Date: <br />