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Owner: <br />� <br />APPLICATION for <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 (425) 257-8810 <br />PUBLIC WORKS PERMIT REQUIRED? <br />�,�����L, �-�,L;� <br />� <br />Date: 7/10/2015 <br />Bldg Permit #� B1 � - <br />� <br />Mailing Address: <br />PANG QINGLAN & DONG CHUN 5530 S 3RD AVE <br />EVERETT, WA, 98203 <br />Contact: <br />[ContactName] <br />Description of Work: <br />Site Address: <br />Legal Description: <br />Comments from Reviewer: <br />Contact E-Mail Address: <br />[ContactEmail] <br />ADD 2 DECKS TO SINGLE FAMILY RESIDENCE <br />5530 S 3RD AVE <br />UTILITY INFORMATION <br />Phone: <br />Contact Phone: <br />[ContactPhone] <br />� <br />� � �� ,' �� � <br />.. - � �� `� V <br />VN �,V �� <br />� � _� <br />. �� .�\� <br />� � � <br />� <br />Meter Only ❑ Complete Service ❑ Install per building or per unit? (circle one) <br />Size of water meter <br />City of Everett Sewer: yes or no (circle one) <br />Approved for Issuance by: Date: <br />