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Owner: <br />DYNASTY HOMES <br />Appllcant: <br />OWNER <br />Descr(ptfon of Work: <br />Site Address: <br />Legal Description: <br />u <br />APPLICATION for <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 (425) 257-8810 <br />Date <br />PW Permit No. <br />Bldg Permit No <br />Malling Address: <br />PO BOX 716, EVERETT, WA, 98206 <br />Matling Addrosa: <br />� <br />NEW HOUSE <br />/��!�., <br />,�180F 112TH ST SE <br />LOT B OF SHORT PLAT 1202-9•80 <br />Comments irom Inspector during Initial inspection: <br />� ed �f�, �revlde <br />'/� G � -("� [ S P''�'�}�- � e - <br />�.D.W� �� -l'i�e �c,�.d wid�.lf� GS <br />%� �2 G. `� a A o i <br />✓ <br />Approved for Issuance by: � `�,� " ,.y"✓ <br />12/27/2004 <br />PW 0412-012 <br />C0412-U11 <br />Phona: <br />4252523699 <br />Phono: <br />�d diflvk,� <br />l6<4 d1d <br />il I�ln����� ) ',� � <br />I � �,. <br />�1`� �� <br />� <br />Date � � � �r��' �_ <br />