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. � �l ��� -��a <br /> APPLICATION +for <br /> -�• PUBLIC WORKS PERMIT <br /> r—-� D PUBLIC WORKS DEPARTMENT <br /> D 3200 Cedar Street <br /> Everett, WA 98201 425- 257-8810 <br /> pP� 2 � �G1� <br /> E� <br /> G�-�Y OF �'eNces oate `I 2� la <br /> perm►t S <br /> OwnerName: � �1i'�0.!�� l_ Gl�CQ.�c� ApplicantName: riYWp�t� ,�GUCQOW <br /> MailingAddress: �'��'l 'L �<�l S�. MailingAddress: <br /> �`vCiE� �,.l�i 9�;2�i <br /> Phone Number: Phone Number. cj'�S Z� z,�S�rj <br /> DescriptionofWork: �\QQU�S+ 'TpilCe. �IU �7�'�� 'T'��w� "Cta��t CGltn�l �'1 �o���. <br /> (�'`OII� -1'�Q �1��11 �Id�. � CO�l��r\VE U� '1�7 'YN�. SIO�QV.�(�1�. <br /> SO�iC� -1'4v�( 'l. 0� � ��� tQt� i� �Qi4�n} <br /> (A drawing or plans may be needed to ill strate work to be done) <br /> Site Address: �9 1 Z Z,�t�� ��. <br /> Comments from Inspector during initial inspection: , i ` <br /> � I I <br /> � �� �D�''�r/levt� ; 1'-en�Q, �r� �rtN1�' t�v��c a►�� <br /> �j��F� � � ��'� �----J' _ <br /> —� � ,� � � �� Vl,fi� -� so� <br /> `7,���1-� ��� wcl:� �` nv��lot k-X�cPd �7 ' � iv� I� - I �-�j�✓IS�►�l I <br /> p(� L�_ 71 —�� �E:,2 /�Tf�C FJ�'17 /��� <br /> Approved for issuance by: Date: <br /> J <br />