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J . <br /> • , <br /> UTILITY PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cr f)AR S I RL[: 1 I_NLIRL:11, WA 98201 <br /> 425 257 8810 - FAX 425.257-8857 - www.everettwa.org <br /> ,-,zip-( eeace <br /> PROJECT ADDRESS <br /> C) <br /> EPropproperty Owner <br /> A Mail Address City State/Zip Phone <br /> _ <br /> Tenant Name(If this is for a commercial business) <br /> 15 4,4 ae&aTdoc/70-4--:krie-otet;,--, 56)3 1(2-2-kOcfpie-1:11-11-e-,4:7-1k15. t_.)- --6 <br /> Contractor Mail Address City State/Zip , <br /> Phone <br /> '/ r5-&Z /,j„4-:_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 /> IfrInstall Backwater Valve (outside the building) <br /> O Cap off Sewer <br /> O Install Water Meter <br /> 1 rt <br /> : Oos5 <br /> 17 / 5- Pi itmt i # 1 <br /> ;,,qn.tiire f 0 te <br /> ( (D.- <br /> 1 <br />