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_ \ <br /> PW13I1 - �� <br /> t. � �—Application for <br /> �:�-�' �T�� I <br /> Public Works Permit <br /> �„1,��, .:�6i'Jy I <br /> .sa�v Public Works Department <br /> «y� l f 3200 Cedar Street <br /> �`'�'' Everett, WA 98201 425-257-8810 <br /> (� � Date: '�� . 1� <br /> �J- �1 ��.� � <br /> Owner Name: r Q � 1 O.S.)S.Q Applican�Name: �J�Q��'�- <br /> ` ' , \ � <br /> Mailing Address:� ��J e w• Mailing Address: C � ���– <br /> � VV � <br /> Email Address: �— � � � � al�ail Address: _�s�,(��G-- <br /> l �1 <br /> Phone Number. ���• 3 ct' Phone Number: <br /> nta for Permit (Name Phone/Email): Ci �l.('fL �ef�l <br /> `fa,� _as� i'>��k (o� 8 � � o(o . � . e�S - ��, w��C <br /> DescriptionofWork: rf-'�Q�IJ� .SII� �lQ(.� �� IG� � '�I� r���1,��G1__ <br /> �_ — J <br /> (A drawing or plans may be needed to illustrate work to be done) <br /> Site Address: �c� ' �J' �� llJ ,_�)����W�. 9��� <br /> Comments from Inspe�tor during initial insnection: <br /> � � - <br /> Approvedforissuance by: Date <br /> ' i <br /> � <br /> � <br />