Laserfiche WebLink
• <br /> UTILITY PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, IIVI_RE l 1 , WA 98201 <br /> 425-257-8810 -- FAX 425-257,8857 -- www.everettwa.orq <br /> HoWerr <br /> PROJECT ADDRESS <br /> Pe-gel -z79 <br /> Property Owner Mail Address City State/Zip Phone <br /> Tenant Name(If this is for a commercial business) <br /> e&66 dOC/,'& Via, j 5030.` ck--t GqC ril¢ ' l cs--4f 1k1 W.7-51 <br /> Contractor Mail Address City State/Zip Phone <br /> A 11 —&z -7i&5 <br /> WA State Contractor License Number(required) City of Everett Business License Number(required) <br /> Work to be done: <br /> ❑ Side Sewer Repair <br /> ❑ Side Sewer Alteration <br /> ❑ Side Sewer— New Installation <br /> E I Install Backwater Valve (outside the building) <br /> ❑ Cap off Sewer <br /> ❑ Install Water Meter <br /> I I I <br /> 4• 0 <br /> AzDo.COLZ <br /> 9tor/ r5 i,lRmi1ll <br /> siynaiure <br />