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n I1 7�� c ovwQ�`-�'" � <br /> „c�'" <br /> ���,.� Q .r�. o� ��B . <br /> r� <br /> APPLICATION for Co� � <br /> PUBLIC WORKS PERMIT � '�� ��,r� <br /> PUBLIC WORKS DEPARTMENT �, <br /> � 3200 Cedar Street �,L� <br /> Everett, WA 98201 425- 257-8810 <br /> Date !n J �/- r"' � <br /> Owner Name: ��r` ��^� i ;, � (,' APPllcan} Name: ��'".�— <br /> � ;•�r � �'• Di�rk �cl,dChr��, <br /> Mailinq Address: �j '.i', [ .� / /' �� ' NMailing hddress: _ <br /> �,�:.�Nlr �r' /� Sd i�/ > >,� � <br /> i <br /> Phone Number. �i��� � '�%; ti� "�d Phone Number. <br /> Description of Work: �������';- ,� ��,rt:��.( ,� � ,.','..'. y S ru. � c • �, <br /> �:���� ��nPass �aSc' �ac, (i�y <br /> (A drawing oi plans may b� needed to illustrate work to be done) <br /> SNe Address: ; � �-- l r� r � ; , . � l '� . � �. •,t�./ t� '�i <br /> Comments from Inspector during initial inspection: <br /> -1, �ti(�r? � l�✓ S�-r�:.� ��Cn�� n� �'i�� T/I�iCS <br /> / 1 <br /> � �!'C��'� (�i lr��i�/ {'7C.C �'Ss4l� �/ EhCS�D� � r0�ifnt�� AS <br /> / � <br /> c� �rcc�ccl �� f�ic �h[i< <�'�'���s Insfcc-�-ol- <br /> �C:. � ��'. nt �'�VS� � I�S/I'OS��OC�� D�" Q�TY1Cv� L✓.St' �/�C�'{LC1 <br /> i <br /> �16 Sl�o,�fr� r�fc�- �'.,,,J•• �'� „�shcd , <br /> Approved lor Issuance by: Date: <br />