Laserfiche WebLink
I <br /> ��I��� ����I�� ��������I�� � <br /> . � CITY OF EVERETT PERIIAIT SERViCE� . <br /> 3200 CEDAR S7REET,EVERETT, WA 98201 <br /> 425-257-8810 = FAX425-257-8857'-.www.everettiva.org ,: <br /> - ��O 1 �t���. � �:. <br /> PRWECT ADDRESS " <br /> ��t�r�l - �pl W�l . �`�2�� Z�12Z <br /> . � �.PropertyOvmer � � - � - : �SailAddmss � � Ci,y � � � StalefLip� � � � �Phone� <br /> ��Tenant Name(If this.is(or a commercial business) � � � � � � _ . ..��/;� � <br /> ��e�.v� ?��1� �c�1�Co ��f 7� <br /> � ��.�Conliador.' `.. MailAddmss' ` . �C�ly':-� � . . � . MLD'.. � � � � Phone . . <br /> Sf.'W����Z.� 1'�'1s d � � � j <br /> � WA�State Confrador l�cense Number(required) �� � . � � � City�of[veceli Dusiness Licensc Numbcr(rcquirc�� � <br /> . . , . -. . ,. . . . . . <br /> < .. . ; . ... . . . . . . . . <br /> � .. '�'l� . . � .� � - . � . � <br /> 'Work to be done: <br /> , <br /> , ❑ Side Sewer Repair `. � ' <br /> � , <br /> �� �, ; <br /> '- , � <br /> 0 Side SewerAlteration <br /> ❑ Side Sewer-New lnstallation ` �, ' � " <br /> Install �ackwaterValve outside thc building)' t <br /> � �` � <br /> ❑ Cap off Sewer ' : <br /> � <br /> , ` , <br /> , ` � <br /> f7 Install Water Meter; � � � <br /> FEE <br /> - � <br /> ��i],•':� 5�� , ' PERMIT# <br /> Sigwture Uate � �� � '1��,I' � ���_'�j ( > . <br /> ' ' lJ `� � <br /> �... REVISm I1/19401i � . . . .. . . . .. <br />