Laserfiche WebLink
� ��`��� � � V ����lO� ������ E��`�`��� <br />C9'y �' S?:= �V�RE i ?�' f�� �i�i"f" ����ief;E> <br />:�200 CEDAR STREET, EVERETT, VVa 98201 <br />425-257-8810 - FAX 425-257-8857 — ��.v,�;�.everetha�a.org <br />�Zol G r�e� � <br />32c�1 33�. St <br />PROJECT ADDRESS <br />tv!a�l Atloress <br />Tenant Name (I( this is for a commercia� business) <br />/�'/�o/% P%r��.%�� �s S Y�=7 7/f r.'�� .,/;� <br />Conitadof A1ail Adtlress � ���Y <br />/�f �G G PG�c 3 GT <br />VJA State Contractor License �umber (requvzd) <br />Work to be done: <br />❑ Side Sewer Repair <br />❑ Side Se�ver Alteration <br />❑ Side Setver — New Instailation <br />�Install Backvaater Valve (outside the building) <br />❑ Cap off Se�.ver <br />❑ Install Water Meter <br />ure <br />Fev�scn i vis�oie <br />tJuL-�" <br />City <br />�t`5�—o ( <br />SiatelLp <br />State,Zp <br />'�S7—! <br />Phone <br />Phone <br />�S3 �is s <br />City of Everetl Business License IJumber (required) <br />FEE <br />� 3� 00 <br />PERMiT# <br />u I�D(�-p�� <br />�� <br />