Laserfiche WebLink
������� ������ ����0������ <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 />� �,r,� � /"/ a}- /) /�� �1- /-1-✓� <br />--� <br />PROJECTADDRESS <br />Mail Address <br />Tenant Name (If Ihis is (or a commercial business) <br />Gty <br />State2ip <br />8� 4Ky <br />Phone <br />y% c.i,r roo�/Z Cd.vs�' b�vi4// �//� 9�'da- `fRf<�x-y�Y/_ <br />Contraclor tdail Adtlress � City StalelZip Phone <br />/�� E's Fc � viH �''� <br />WA State Contractor License Number (required) <br />Work to be done: <br />Side Sewer Repair <br />❑ Side Sewer Alteration <br />❑ Side Sewer — New Installation <br />❑ Install Backwater Valve (outside the building) <br />❑ Cap off Sewer <br />❑ Install Water Meter <br />. <br />REVISED If/f9/10fa <br />D2,� D%� <br />City of EvereU Business License Number (required) <br />F[E <br />�0•Oc� <br />PERMIT# <br />� �SOZ-Oz�f <br />