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2119 LOMBARD AVE 2016-01-01 MF Import
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2119 LOMBARD AVE 2016-01-01 MF Import
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Last modified
2/17/2017 5:35:59 PM
Creation date
2/17/2017 5:35:48 PM
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Address Document
Street Name
LOMBARD AVE
Street Number
2119
Imported From Microfiche
Yes
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a <br /> j.� <br /> ' �_ <br /> _. _._._ .__ ._— _._'_ — <br /> UYILITY PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EV[RETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> � // 5 �Oti-i G.���ct fj?�- � <br /> PROJECT ADDRESS <br /> ��y�-rhl�-� 2�� s 1� 6� t�-� ww- -���—� . <br /> Pfoperty�wn Address City S�ale/Zip Phone <br /> Tenant Name (I(�his is for a commercial businNss) <br /> �� fi/''���J�{�%11� d�o!f (//,f7�Ya�t-�- �- � I� �fc4 5'`6lz-� <br /> Contractor Mall A ress City StatelZ�p Phone <br /> /�-f� f�/�v�y-�' (JI//��4 (� S Z SS6 <br /> WA S1ale �oNractor License Number(reouired) Cily of Everett Business License Number(required) <br /> Work to be done: <br /> ❑ Side Sewer Repair <br /> ❑ Si�1e Sewer Alteration <br /> ide Sewer — New Installation/�'�l� `� <br /> I J <br /> I ❑ Install Backwater Valve (outside the building) <br /> ❑ Cap off Sewer <br /> ❑ Install Water Meter <br /> FEE <br /> �v� <br /> /�G��-- �JR�C'L� � 3. 2 !�� PERMIT# <br /> Signature Date � <br /> Iso3 - I �`� <br /> ����sF�,,,,�,,.,,: � <br /> -------- ---- - I <br />
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