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- _ - -- - _i <br /> . j <br /> i <br /> �`��Y�W V��' ��f}�Yii':�� ,a��'�[���.�: Il G��9 i <br /> CITY OF EVERETT !'ERM��" SERVIC�� � <br /> 3200 CEDAi� STREET, EVERETT, WA 98201 <br /> I 425-257-8810 - FAX 425-?_57-II657 —v�w�r�.Fvere?hva.ory � <br /> I <br /> I <br /> I /2_3 � l�om�rr.� 1.�.1�'D:— � <br /> PROJECTADDRESS � <br /> I <br /> �__�'�, �a� y�2S �q 6� P�,u� 1�,� . �_ 1,c�1a _��Z23 : <br /> Properly0lvner �v�ailAodress Gly Sate:2��p Phonc i <br /> I <br /> Tenant Name (R Ihis is for a commercial business) � � <br /> I <br /> Ua�.��.�.� C'�,��,,���,.�?,���x ,��� �l��,;,,�, ��; 2.0� �� s ;��'� � __ ; <br /> Con(factor P.iail Address City StatelZip Phone � <br /> L,��c�cv��L��� I�� G� S 2_�( 7 � ; <br /> WA Slate CoNractor License Nurnber(required) City of Everett 6usiness License Number(requ�redj I <br /> I <br /> Work to be don�_: � <br /> I ❑ Side Sewer Repair <br /> ❑ Side Sewer Alteration I <br /> I <br /> ❑ Side Sewer— Ivew Installation <br /> i <br /> �Install Backwater Valve (outsiJe the building) <br /> ❑ Cap off Sewer I <br /> ❑ Install Water Meter <br /> FEE <br /> %� Jb <br /> �� , <br /> S PERM1Trt <br /> �r Dal � �����Dn� <br /> �; <br /> RCVt5E0 rl/I9?9ta I <br />