Laserfiche WebLink
�TILI��" �'ERMI� �PPLI�ATION <br /> Cl�lf �F EVERE7�' PERMIT SERVICES <br /> 3200 C[DAR STREET, �VERETT, WA 98201 <br /> 425-25�-8810 - FAX 425-257-8857 —tvww.everettwa.org <br /> �<�37 �'eri�.�e �l'Z <br /> PROJECT ADDRESS <br /> G�iriS �ll'�/Scn <br /> Property Owner Matl Address City StateRip Phone <br /> Tenant Name(IF this is for a commercial business) <br /> �"/v//ci /�%u./i13�,-�� _S `/o7 7lrArz ..ic, r+u�ySv,ii� w/1' lP$�7�i 3.�7�/So7 <br /> COnlracto� `4ail Address City State/Zip Phone <br /> /�f�G G PG�c 3�7' oS.3�/s.f <br /> WA Stale Contractor License Number(required) Cily of Everett Business License Number(required) <br /> Work to be done: <br /> ❑ Side Sewer Repair <br /> ❑ Side Sewer Alteration <br /> ❑ Side Sewer — New Installation <br /> �Install 13ackvdater Valve (outside the building) <br /> ❑ Cap off Sewer <br /> ❑ install Water Meter <br /> F[E <br /> 3�`� <br /> --- `�/�- �/� r��rzr��ra <br /> Sign2ture �atc � n l r ^� _ /� I^-� <br /> U � (1 `1 S <br /> REKgrD f f/f 9.ro l a <br />