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4 Pf/NL/C WO?/C5 <br />JIT Address Application <br />Buildin T e: ❑Nets i _ erify [JPreliminary (future) <br />please complete numbered items (I-7)and submit bye -mail to: mholey&l.everett.wo.us Coll 425.257-8813for other options. <br />1. Relationship to owner: AS e,+ Date: 5•26-13 <br />2. (a) Your name and mailing address: (b) Phone: (c) e-mail: <br />Cra;9 Kooh rh NId 'fzs-8764S(7 <br />2t , 6M A✓ (ortjkpehhome5LO,ao(,c0A, <br />S rnwoocl tup ngz4Z <br />3. Date needed (please allow up to 4 weeks for assignment or verification): <br />4. Primary address application: 3609 F-nr( Ave X Crv1�ro_I UJ1) <br />5. Supporting information and current use of primary address (licenses, marketing, etc.): <br />C"-Fy recorje, '24+ow 3606 Earl Ave home <br />o4er rccords- 7ikot✓ 3606 <br />6. Site plan attached (recommended to expedite request): <br />7. (a) Owner name and mailing address: (b) Phone: (c) e-mail- <br />Kenfttth rGyn+h�a Mar+tn r{753'08 tf153 <br />75600 Earl A✓c 3` <br />&.Varetf- WA g0201 <br />r7ora: <br />Current Parcel Address: <br />FOR OFFICE LISE ONL Y <br />Suggested Parcel Address: <br />Owner written approval to revise parcel address received: <br />owner written approval for city proposed address received: <br />COE Master Address: <br />Go Sync GIS Map Address: <br />Microfiche: <br />utility fulling: <br />(IN <br />Permit Service:: <br />lf,o& Cr 0 <br />3(,o $ t:UrI <br />Field address verified with photo: <br />kle <br />Application form available online at http:/Iwww.evere.ttwa.org/get PDF.aspx7pdflD=5448 <br />R <br />.i. Yes / No <br />e *, <br />kc �ent�1 <br />tog No.: <br />❑ Yes No ❑ <br />❑ Yes / No ❑ <br />❑ Yes / No ❑ <br />Updated 2/23/2012 <br />LLJ <br />