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0,0 t50.6 -- 038' <br /> ,vE <br /> Application for <br /> ff4P7 <br /> Public Works Permit <br /> Public Works Department <br /> tfr yLf F7 TT 3200 Cedar Street <br /> Everett, WA 98201 425-257-8810 <br /> p Date: <br /> Owner Name: 1 E1,Q.k- pF Eva2i' Applicant Name: — Skrv.e. — <br /> Mailing Address: e0 £o1 5SZ. Mailing Address: <br /> eve. . WA, °B2O(0 <br /> Email Address: $a.¢. toe—o% Email Address: <br /> Phone Number: S-tet, toe, oW Phone Number: <br /> Contact for Permit(Name Phone/Email): GgA1-65rtm 4NAL/LSor f, &ur.ec4-o.2.ot= RANNirj& <br /> • <br /> • of c Se: — o o GLs, Av."-oJ Par2-kof yens, <br /> Description of Work: 1)042t T2Qwt i n1Al.. Up 62A415 I1�tS-e <br /> CP(941-e, 14646-0 eg.o-ye D2SCaet p4-t:ort) <br /> (A drawing or plans may be needed to illustrate work to be done) <br /> Site Address: <br /> Comments from Inspector during initial inspection: <br /> Approved for issuance by: Date: <br />