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2121 FULTON ST 2016-08-15
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2121
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2121 FULTON ST 2016-08-15
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Last modified
4/7/2017 7:16:02 AM
Creation date
8/11/2016 2:35:16 PM
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Address Document
Street Name
FULTON ST
Street Number
2121
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__ _ � <br />• <br />UTILITY PER.MIT 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 />2� 121 �i��.�Zl� S��i� <br />PROJECT ADDRESS <br />Property Owner <br />Mail Address <br />Tenant Name (If this is for a commercial business) <br />��,�� <br />Contractor <br />�► �1�, <br />Mail Address <br />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 Instaliation <br />❑ Install Backwater Valve (outside the building) <br />�I Cap off Sewer <br />� Y <br />❑ Install Water Meter <br />REVISED 1 i/19/2014 <br />City <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />City of Everett Business License Number (required) <br />FEE, <br />� �Q �� <br />, <br />PERMIT# <br />� I 5��--D�C� <br />
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