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� � <br /> � �'`�` APPLICATION for <br /> :t <br /> PUBLIC WORKS PERMIT <br /> ,����E't��ETT PUBLIC WORKS DEPARTMENT <br /> ���_� <br /> 3200 Cedar Street <br /> "" Everett, WA 98201 425•- 257-8810 <br /> Date `� � t7/� � <br /> Owner Name: rn�"G�'� ��t�'1 Applicant Name: S�✓�F <br /> Mailing Address: 3� � � ��'� �e^"'� Mailing Address: <br /> �'v�'n -�'�n'1-1' l�.i/k cl�Z v � <br /> Phone Number: �L+j - 3'2, q 3 3�g Phone Number: <br /> 1 G�j� <br /> Description of Work: �'e ��^� Q X� S�+r �'Z �� CQ �'��1 UC (7► <br /> 1� . ��11�� Y1Pc� �.�jc%�;� .�n V�o/��, Gr� SW�I., <br /> U� A��� ���� � a' �G''��?i1d� C_ `.��`��� If i �1�.�(.l T�nQ.Q l/d��f� JL�Q� ' . <br /> 1 ' <br /> (A drawing or plans may be needed to illustrate work to be donel . " <br /> � <br /> �ve�� ir- (/�c l �Q� S'�,►"��"� (p ��b` �1�5 , <br /> Site Address: 3 � � � �`I��fi t"�'��/'��f ��L'�'t �"�. I�1( S�f'�`1 l0 �'O'� <br /> , V, Sv ;[.ck �-. ��n,}�S �p/�dvL� <br /> Comments from Inspector during initial inspection: <br /> �� d� y� � � <br /> 5 <br /> L�� ������ �C� . { <br /> I� � - <br /> APR � � z�oa <br /> CITY C�F F�,�ERETT <br /> PC;i�i�E� r.. .,. , ,.'�?'at` ,...�..... <br /> Approved for issuance by: Date: <br />