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�—APPLICATION for <br /> PUBLIC WORKS PERMIT <br /> EY E17 PUBLIC WORKS DEPARTMENT <br /> 3200 Cedar Slreel <br /> Everett, WA 99201 (425) 257-8810 <br /> PUBLIC WORKS PERMIT REGIUIRED? <br /> Date: 413012014 <br /> Bldg Perrnit #: 61404•044 <br /> Owner: Mailing Address: Phone <br /> CARTAGENA SUSANA 1306 108TH AT SW I,�(���� V �n <br /> EVERETT, WA, 98204 )u App a n : , <br /> Contact: Contact E-Mail Address: Contact Phonc: <br /> F,,, _ <br /> [ContactNamej [ContactEmail] � [ContactPhone] <br /> Description of Work: NEW CARPORT <br /> Site Address: 1306 108TH ST SW <br /> Legal Description: <br /> Comments irom Inspector during initial inspection: <br /> !�� � � ��1 <br /> l �D <br /> Approved tor Issuance by: Date: <br />