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�� c���� ��- <br /> Application for <br /> ,�,�r � ; s r;t.r <br /> �L�:'��, -,, Public Works Permit <br /> _ ::t4 Public Works Department <br /> ' { � � � 3200 Cedar Street <br /> :;F - <br /> Everett, WA 98201 425-257-8810 <br /> Date:� " / � r�f <br /> Owner Name: ��'� �Q,S �.-•(�� Applicant Name: �C�,y�J� ���(,(LS(�L� <br /> Mailing Address: ���� � 1 ����o_JT�� Mailing Address: <br /> I <br /> �t���l�r�m���� ��JA G � 2�C� � �-� <br /> Email Address, " ' ' ' + G ( Email Address: <br /> � VV I�. I � <br /> Phone Number: `�'Z.S.(,/O.� � Q�� Phone Number: <br /> ; .I � <br /> ContactforPermit (Name/Phone/Email): f(�" T C�II'�Sj �1'L�����. �� Z <br /> C�C��.-���►(;P ��G(T� � I .Ce��%� <br /> �1,,� _I ' ,' ) <br /> Description of Work: l..C_)�►�.�..7T�'1.�G��YL.� � ��-�V� ���.p�,�'i� �v 17'�L <br /> Q.II � r �� U�� II �s <br /> (A drawing or plans may be needed to illustrate work to be done) <br /> Site Address''�� � r��� ��d�l ��C�/�c� � V((`f s �� � � �'� � <br /> Comments from Inspector during initial inspection: <br /> �� �� c� �(/��s C�' �5��-� �t5�(o-dC� <br /> �'� �_ z��>� � <br /> Approved for issuance by: Date: <br /> �,o l��C� �(�5 c v� �ao�.���I� <br />