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• • <br /> APPLICATION for <br /> i� PUBLIC WORKS PERMIT <br /> A• 'ETT PUBLIC WORKS DEPARTMENT <br /> 3200 Cedar Street <br /> Everett, WA 98201 (425) 257-8810 <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> Date: 9/14/2015 <br /> Bldg Permit #: B1509-018 <br /> Owner: Mailing Address: Phone: <br /> ROSEN BEL-KIRK ASSOCIATES PO BOX 5003 <br /> BELLEVUE, WA, 98009 <br /> Contact: Contact E-Mail Address: Contact Phone: <br /> [ContactName] [ContactEmail] [ContactPhone] <br /> Description of Work: DELIVERY RAMPS-PPG ARCHITECTURAL COATINGS <br /> Site Address: 15 SW EVERETT MALL WAY <br /> Legal Description: SEC 24 TWP 28 RGE 04 <br /> Comments from Reviewer: <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 />