Laserfiche WebLink
UTIL#TY PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257=8810 FAX 425-257-8857—www.everettwa.org <br /> 15 S Lob <br /> PROJECT ADDRESS <br /> Property Owner Mail Address. City` State/Zip Phone <br /> Tenant Name(If this is for a commercial business) <br /> oeitl P4414.1191'0,y 17:51 S 151- SI-. SF= i-4/14 c7kz4la Ll2S 7 E3C.) <br /> Contractor 'Mall Address City State/Zip Phone <br /> WA State Contractor License Number(required) City of Everett Business License Number(required) <br /> Work to be done: <br /> C7 Side Sewer.Repair <br /> 0 Side Sewer Alteration <br /> 0 Side Sewer—New Installation <br /> Install Backwater Varve (outside the building) <br /> Cap. off Sewer <br /> o Install Water Meter <br /> FEE <br /> — I) PERMIT# <br /> Signature Date <br /> UIC$ D3- (9(q <br /> REVISED 11119/2014 <br />