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4030 RUCKER AVE 2022-05-13
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4030 RUCKER AVE 2022-05-13
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Last modified
5/13/2022 1:55:05 PM
Creation date
6/27/2017 1:33:34 PM
Metadata
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Template:
Address Document
Street Name
RUCKER AVE
Street Number
4030
Notes
BACKWATER VALVE
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lJ �iILiTY PERMI`� A��L��ATYOfV <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-881 D- FAX 425-257-8857 — v,�wv�.everettwa.org <br />�03�� ,A�,�o,� �� <br />PROJECT ADDRESS <br />_�on�� �. �� \ <br />Property wner I:lailACdress <br />Tenanl Name Qf this is for a commercial business) <br />1 <br />COntf�ClOt �dail Addre55 <br />��E�IUEU ���tl_.�41 <br />'NA Slale Contracicr License Number (required) <br />Work to be done: <br />� Side Sewer Repair <br />❑ SideSewerAlteration <br />❑ Side Sewer — Ne�v Installation <br />Cily <br />�Install Backwater Valve (outside the building) <br />❑ Cap off Sewer <br />❑ Install Water Meter <br />City <br />��� , s <br />-- „��� - ----------��?,�,-/--- <br />� <br />P! leSf�O 11/12^OIJ <br />Sidtc2ip <br />Stale/Zip Phone <br />Phone <br />DS�—�7� <br />City of [verett E3usiness License Number (required) <br />PERMIT7! <br />U I�b�-Oq`6 <br />
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