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ti r <br /> R <br /> ti4 _ <br /> APPLICATION for <br /> PUBLIC WORKS PERMIT <br /> PUBLIC WORKS DEPARTMENT <br /> EV ETT 3200 Cedar Street <br /> Everett, WA 98201 425,; 257-8810 <br /> Date —`3 <br /> Owner Name: 1' U�-� � '� Applicant Name: C'K 1dtS <br /> Mailing Address: t"� �� 1?;f-00,E Od-u Mailing Address: <br /> Phone Number: —(212 3 Phone Number: <br /> Description of Work: VCA--\I'e- (!)j X, <br /> (A drawing or plans may be needed to illustrate work to be done) <br /> Site Address: w Ct <br /> Comments from Inspector during initial inspection: G% 0 �✓G� !11 SsE�� <br /> �IYL <br /> V � <br /> Approved for issuance by: Date: <br />