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3119 LOMBARD AVE 2022-04-29
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3119 LOMBARD AVE 2022-04-29
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Last modified
4/29/2022 4:01:33 PM
Creation date
4/29/2022 3:54:40 PM
Metadata
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Template:
Address Document
Street Name
LOMBARD AVE
Street Number
3119
Notes
BACKWATER VALVE
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' -- --_- — --- - -------- - <br /> - -- -, <br /> i <br /> i <br /> ���fL�`��' ����'�V� �,�'�'���A�G��9 , <br /> � CITY OF EVERETT' 'PERMI(' iERVIC�� j <br /> ; 3�00 CED.�R STREET, �VER6TT, WA 98201 � <br /> � 425-257-8810 - FAX 425-257-8857 —wwvd.everettwa.org ' <br /> I <br /> I i <br /> I ! <br /> I i <br /> I �/ !9 /..om f� (/E <br /> � <br /> I PROJECTADDRESS I <br /> i � <br /> i o.vr'r� �� �S S�� 1��n�.� 1.1/� _����'I�S ; <br /> � P� pertyG�•:ner Ma�lAddress Gty State2ip �'�.cne ! <br /> I <br /> I <br /> Tenant Name Qf ihis is for a commerual business) � <br /> i <br /> UJ�.Iu�,� ���t����,��.�� �OR�k 1K�1 �'�1������, �� 2.o� 7Y3 �� 1 � <br /> Contractor P�taJAddress C�ty State/Z�p Phone I <br /> � �.�F��u�ct`�g�t 1.�'� D 5 Z_'� 1 � � <br /> WA Sta�e CoNrac�or License Number(reGuired) City of Evere(t Business License Num6er(required) � <br /> Work to be done: I <br /> I <br /> � ❑ Side Se�ver Repair � <br /> I ❑ Side Sewer Alteration <br /> I <br /> I <br /> ( ❑ Side Sewer — New installation � <br /> I <br /> �Install Backwater Valve (outside the building) I <br /> I <br /> ❑ Cap off Sewer <br /> ❑ Install Water Meter <br /> rEE <br /> �� �a <br /> �� PERMITJt <br /> re Dal � — <br /> �"�"' U i�D��D �(� <br /> RFNSEO 11/19ROla <br />
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