Laserfiche WebLink
������ ������ ����������� _ <br /> G@� OF EV/ERE�'T ��RMIT �ERVBCES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257=8810 - FAX 425-257-8857 —www.everettwa.org <br /> �829. Oa[!�5 C�z57 <br /> PROJECTADDRESS <br /> �w�w�, J�Uqv� �i2eC��� � �pte2p ��� �� Phone <br /> Property O�mer <br /> Mail Addmss Ci <br /> •n��n�_ <br /> Tenant Name(If this is for a comrnercial business) <br /> C`i '—S) � � <br /> a, C�L. %�tc,ljc� `�. CUi��i:l i,vA � �[�„52.0� �` ano� t� �i <br /> . C� St21elZip <br /> ContfaCtof . {14ailF.ddress <br /> � � K � ��3 ���(f3 <br /> � ����E� l 5� � Ci}y of Eve2tt Business�cense Number(required) <br /> WA State CoMracror License Number(reqwred) <br /> Work to be done: <br /> ❑ Side Sewer Repair <br /> ❑ Side Sewer Alteration <br /> ❑ Side Sewer— New Installation <br /> p" Install Backwater Valve outside the building) <br /> ❑ Cap off Sewer <br /> ❑ Install Water Meter FEE <br /> .30°� <br /> PERMIT# <br /> i.( � oate � I 5 O-rj—�� I <br /> Sig et� / <br /> aEVAm7�tt9/tofa <br />