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1132 RUCKER AVE 2022-05-12
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1132 RUCKER AVE 2022-05-12
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Last modified
5/12/2022 8:56:30 AM
Creation date
5/12/2022 8:56:04 AM
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Address Document
Street Name
RUCKER AVE
Street Number
1132
Notes
BACKWATER VALVE
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UTI�,ITY PERMIT APPLICATION <br /> � CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> ll3Z �luc � cl� <br /> PROJECT ADDRESS <br /> � UC � SG �✓ <br /> Propehy Ovmer t;�all�tldress Cdy Slate/T_ip Phone <br /> Tenant Name (If this is for a commercial busmess) <br /> LY�1 PIJGI/S il!'n <br /> CoNractor MaAAddress C�ly State2�p Pnone <br /> Cq� /Jh%1� y/7�is � y � 7� � — <br /> WA Slale Contracior License Number(reqwred) City o(Everetl Busmess License Number(required) <br /> Work to be done: <br /> ❑ Side Sewer Repair <br /> ❑ Side Sewer Alteration <br /> ❑ Side Sewer - New Installation <br /> � Install Backwater Valve (outside the building) <br /> O Cap off Sewer <br /> ❑ Install Water Meter <br /> r-et <br /> //,�j `�3D. °°� <br /> / !' .l /"(/ ���/�L P[RM1T# <br /> u� <br /> S�gnaturc Dale U 15DC� _O(/ I <br /> ncv:yEo i in o.n;a. <br />
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