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r <br />• <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 />Date: <br />Bldg Permit #: <br />Owner: Mailing Address: <br />PFEIFFER CAROL/FAIRBANKS NANCY <br />ROCKEFELLER AVE <br />Contact <br />[ContactName] <br />Description of Work: <br />Site Address: <br />Legal Description: <br />Comments from Reviewer: <br />EVERETT, WA, 98201 <br />Contact E-Mail Address: <br />[ContactEmail] <br />REPLACE 21'X10' DECK <br />3616 ROCKEFELLER AVE UNIT A <br />9/3/2015 <br />BW1509-001 <br />Phone: <br />3616 <br />Contact Phone: <br />[ContactPhone] <br />No Publtc. (��rl� C�ne,�r�s <br />� No pW � �/�mi�' <br />� No N� UTIG�TIF.�' <br />—/�fi CN��i. E 0 F USE <br />UTILITY INFORMATION <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 />