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:£ APPLICATION for <br /> PUBLIC WORKS PERMIT <br /> EV ETT PUBLIC WORKS DEPARTMENT <br /> 3200 Cedar Street <br /> Everett, WA 98201 (425) 257-8810 <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> Date: 7/27/2015 <br /> Bldg Permit#: CW1507-005 <br /> Owner: Mailing Address: Phone: <br /> SHAFFER AMY PO BOX 613 6316870027 <br /> BAYPORT, NY, 11705 <br /> Contact: Contact E-Mail Address: Contact Phone: <br /> HOLLAN JAMES "JAY" 4252592592 <br /> Description of Work: 2ND FL ADTN, REMDL&KTCHN ALT <br /> Site Address: 4916 VISTA PL <br /> Legal Description: <br /> Ido Poi � <br /> Comments from Reviewer: No nFw <br /> :��No fF'fs <br /> /ala Jmgs ease. <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: 0 15 <br />