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_ - — . __ _-- _ _- -- - -- -- <br /> � - _ _ _ <br /> ' IiTILITY PERMIT APPLICATION <br /> ;� CITY OF EVERETT PERMIT SERVICES <br /> ' 3200 CEDAR STREET, EVERETT, WA 98201 <br /> I 425-257-8810 - F,',X 425-257-8857 - www everettwa org <br /> I <br /> �� 2 � i � - �3 � k� �1 � �- � <br /> , PROJECT ADDRESS <br /> � <br /> ���- �J�`, -S----- C�t v✓�� <br /> Property0wner ldanntldress C�ry Stale2ip Pnone <br /> � ----- --- --- -------� -- <br /> � Tenant Name Qf th�s is for a commercial business) <br /> Zp� J CLi (�=SIPC` �`P� � Z � �llYj <br /> ��-� ��I S�w�� s IN�- C�r�G�,� ls � � 9� z�z' � � �a � <br /> -�- - - --�-- — <br /> 'I CoNrdclor �.�atl�daress City State/Lp Pno�e <br /> � � T2i � ST qz � J � � �' 3S � Y <br /> IlNA State Contractor Gcense Number(reqwred) Gly of EvereO Business License Number (requ�red) <br /> I <br /> i <br /> � Work to be done: <br /> � ❑ Side Sewer Repair i <br /> ❑ Side Sewer Alteration I <br /> I <br /> ❑ Side Sewer - New Installation I <br /> � <br /> �Install Backwater Valve (outside the building) <br /> , <br /> i <br /> � U Cap ofi Sewcr I <br /> ❑ Install Waler Meter - -- � ! <br /> FEE <br /> 30°`' <br /> 2�. -- -- __ - � <br /> y ��s �_ �S � PEHr�n�n <br /> -- -- -- _ -- --_ _ --- <br /> ignaWrc Date 1 1 I � � �' ,1 / � <br /> U U YJ <br /> nEeiseo r irr�?ora <br />