Laserfiche WebLink
_ __ _ _ _ --- _ _ _ ---_ _-- -- --1 <br /> ' ' - UTILITY PERMIT APPLICATION <br /> I CITY OF EVERETT PERMIT SERVICES <br /> 3?_00 CE:DAR STRFET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -- n�ww evereltwa org <br /> I <br /> .�.�1-`��� U� <br /> PROJECT AUDRESS <br /> . , (u2�) <br /> ��_,�a.�-¢, ��«12 z�_1�_��?F���a--33�" 5G y5 <br /> Property Ownei I,tad Adtlress Gy State�Dp Phonc <br /> S�-��---_._____._---- ---------� � - ---�--- .._._ . _-- -.___. ..-- <br /> Tenant Name (Il lh�s is 'or i mmmeraai bus�ness) <br /> . <br /> A-lM.ef,�-� c-a�/ ��-�/� I ;�n CkZ.S��/ <br /> ' _�.r�'FI G 7 Jlc��.LL-�.'�S� 2WX?_ �21f[A U��_.rZ�iw "� S c��_zYZ__ Sr _ <br /> �� Conir�ctor , IAa�I Atlaiess City StatNl�p Pnore <br /> , �W�.Cy 2lSS � ��_—_ ���---_ – - <br /> � WA State Contractor license 'Jumber (reqwred) City of[verett Basiness License Number (requued) I <br /> I <br /> Work to bc done: <br /> I <br /> ❑ Side Sewer Repair <br /> ❑ Side Sewer Alteration <br /> i ❑ Side Sewer – New Installation 'I <br /> ! LY Install Backwat�r Valve (outside the building) <br /> ❑ Cap off Sewer I <br /> O Install Water Meter ----- � <br /> FEE � <br /> , � �j O`� I <br /> - --- - <br /> �7 ---- --� <br /> —G� � PERMTT.7 <br /> -.. —__ �9 � e — _ --___—____�_—_—. Date -_ __.__.__ <br /> - ___ -___.____ _ <br /> �� I `� o'�- 01 i <br /> nFWSCU rrq9r:p�a <br /> �___—.. - _—__—_— —. —__" _' _ . __—___.._._._"._—___. _� <br />