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�'���`� c <br />� <br />APPLICATION for <br />{�UDLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Sireet <br />Everett, WA 98201 (425) 257•8810 <br />PUBLIC WORKS PERMIT REQUIREll? <br />Owner: Mailing Address: <br />SERGEYEY DINA 8 SERGEYEN L[ OwnAdd), EVERETT, WA, 98203 <br />Description of Work: <br />Site Address: <br />Legal Description: <br />BEDI300M ADDITIONS <br />5506 S 3RD ST <br />Comments from Inspector during Initlel inspection: <br />A;�proved for Issuance by: <br />\ <br />��.-...�+ Raj�ii,-r«i <br />. / � (.v � <br />/Y� �''�,� � <br />;_I V � <br />5/� i/ � <br />�. �// '/ l� i <br />� �,-z , � c , r� �� <br />Datc OS/28/2f 02 <br />�LDG Permit No. 60205-Od5 <br />Phone: <br />[ OwnPhone] <br />Date `� ✓�' /C z" <br />