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1005 GRAND AVE 2019-01-28
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1005 GRAND AVE 2019-01-28
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Last modified
1/28/2019 2:23:49 PM
Creation date
1/28/2019 2:23:41 PM
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Template:
Address Document
Street Name
GRAND AVE
Street Number
1005
Notes
BACKWATER VALVE
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UTILITY PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR S FRI 1 1-, EV1:R1 11 , WA 98201 <br /> 425-257-8810 - FAX 425-2578857 wwweverettwa.org <br /> (9V5 M411 A–Ord-- <br /> - <br /> PROJECT ADDRESS <br /> e-Or /1124>J5/TrF q'zs--V3 -9e16 <br /> Property Owner Mail Address City State/Zip Phone <br /> Tenant Name(If this is for a commercial business) <br /> • 7, <br /> --fe3 V <br /> Contractor Mail Mail Address City State/Zip . --- Phone, <br /> 24 <br /> I - •„) d)-_-5-1)/6) _7 _— <br /> WA State Contractor License Number(required) City of Everett Business License Number(required) <br /> Work to be done: <br /> O Side Sewer Repair <br /> O Side Sewer Alteration <br /> O Side Sewer— New Installation <br /> Install Backwater Valve (outside the building) <br /> O Cap off Sewer <br /> O Install Water Meter <br /> FEU <br /> 3boroe, <br /> / I <br /> Au-A-C / <br /> ifin„„„„ ZZ12-e-c--- 573 ( <br /> Imt(! ptimi <br /> U1506 - 0649 <br />
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