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Owner Name: � �v ' `� <br />APPLICATION for <br />PUSLIC WORKS PERMIT <br />FUBLIC V�JORKS DEPARTMENT <br />3200 Cedar Street <br />Everett;"dVA 98201 (425� 257<8810 <br />�i�)�o�-Os � <br />� <br />Mailing address: 3�i l`l �C-Ti, Sf <br />�r/Pre � W� /�ZU � <br />Phone number: "! �� 7S0 gl �� <br />Description of Work: <br />� G <br />O7�'t <br />Site Addrass: � y�� �6r� S t <br />. <br />�C��f�UM[� � � <br />� �D <br />JUh � � �pQ3 <br />CITY 01� f�VEHE1"j' <br />Permit Servir,es <br />Date � - z �{- ° 3 <br />�.�„/, 'n l/yl /a ? tn ,' es u "1 <br />Mailingaddress: 3��/Li �CTh f'1� <br />�cie (�T'1" (.�� %f?c � <br />Phone number:� =' � 7�� `� � � � <br />�� �j� G� �1�'r��� <br />ril � � �� �� <br />Comments from Inspector during inStial inspection: !�✓1j�� l� ��� o� C�" <br />i�o��m��� d��-� �w����� �( 11� `1 �//� <br />t C lhr✓ S' 1n {� Lr L*�•eeY S/w <br />L�u i ll �� 6-L- ��l GL�.�i �,n i a_ ,�_ d� �, � <br />�NI7tAL �NSPECT6Q�. �+ w�l� � vt-s�n" b e ��^ eve�..����I�e� <br />`<IRK BROOK£ wG a--�1 t�^-��`w��� c�l �w <br />�''i'�ls' � u Ga�� �.:�� <br />UATL _ __._.._ <br />(� /a l,/U 3 <br />� �1 <br />� � ,, <br />,% , z �_SG'/ <br />qpproved for Issuance by: l/ C�/h l t�r ` Date Q <br />,r � � . // /� <br />r-%n,;j/G,l:.�� .'_%'US>or. CO��T�'O� P_r. �:'[r �� ��jd 7'j(.' �/�� Y(Jl�i[ C�IOi'�., �/7S/%CG Ol�' <br />� �,,;, ., �. i�`�GC'. .nlv,,., nf n �� fU:�c: �� � <br />�. <br />