Laserfiche WebLink
CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />$T ZV-e,,re % � <br />PROJECT ADDRESS <br />Property Owner <br />16// <br />Mail Address <br />Tenant Name (If this is for a commercial business) <br />IS <br />Contractor fvtail <br />77 S7- ZoE <br />Zile -le 77— <br />A6. PO. (30i( <br />A ess City <br />lf4e / 7 /b,?S <br />WA State Contractor License Number (required) <br />Work to be done: <br />❑ Side Sewer Repair <br />❑ Side Sewer Alteration <br />❑ Side Sewer — New Installation <br />istall Backwater Valve (outside the building) <br />❑ Cap off Sewer <br />❑ Install Water Meter <br />46;7.1 <br />Signature <br />City <br />State/Zip <br />Phone <br />zdjir 42s--Art -- <br />Phone <br />nV "7-7a : <br />City of Everett Business License Number (required) <br />al,7/1s <br />FEE <br />�D °/0 <br />PERMIT# <br />U I'jO�-031 <br />REVISED 11/19/2014 <br />