Laserfiche WebLink
APPLICA <br />Ocaner' s <br />� S[dOH0;1ISA HEALTH DI5IRICT �' <br />Ea•�ironmentai Health Division <br />Court House <br />Everetc, 'Jashington <br />�> r <br />'� ,' ,�' �. - � � "; <br />/ Tax Account Number <br />No. ,.� ., i,r �C- <br />Ovner's Address L-�y/ t�� -.�-.�.,; �.r /r�•�/� a,-: i�-��"� <br />Builder's Pleme L7-� f1'�'1�5F•:' Date Phone PIo. <br />Addreas of Proposed Site,�.!�Ji/ /-� , �'--�-�-�t�'•: �r �r.��.-f� ,__ %/='` � <br />Legal Description L:,r%- .Y r % .��::%'-,✓ /%ilf ^ � �'�.�- ...,�/..- /,�� ,�. ,G; -- <br />ldobile Hoc�e/or �2esidence No. of 6edrnoms Explain F,ddition i���'- ��"; <br />/� r'i,-� //i��.< �l i7re i/G.�' //E�r<. -I./�.%<,_r' � /= .iS�i�v� ��%7i��� S<��,�,; <br />Property Owner will be .iome ��� ��� <br />� i. .. <br />�.'Ji�' .ii,-;i e' �l.�'i)i... -:>i /iN S •'i/'iI' <br />SP.�TCH APPROXI <br />Plan Check P;o. <br />ADDITION: (Give Dimensions <br />_ ' , ... <br />�,�r <br />Accepted !/ Not Accepted _ <br />RErIARKS : / �I �! <br />�F- FT/j'„SI �-G�GG`�r�� ,7� -�S.l�/-�/l`/ T/ .�-"G� _ <br />