Laserfiche WebLink
�_. _. . _ .� _ . . _. __. . _ ._-_-__ ._ _ . .- . . . . -___ <br /> '�� �' UTILITY PERMIT APPLICATION <br /> �� � <br /> I CITY OF EVERETT PERMIT SERVICES <br /> I 3200 C[DAR STREEI', EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 - www everettwa org <br /> I —���"�7�1-/�-�!' � /�� : <br /> PROJECT ADDRESS <br /> �1V�,�_ �l.�ll�� z�ovZ �,r<Y�.v-✓ �. �S�`�/Zol <br /> PropertyOvmer fdadAddiess � Cly Slate/Zip Pnone <br /> i <br /> __. .__._.____ __.__ ____. _____. _. _. __.-- _ ___. .. _-.. — <br /> �I Tenant Name �II this is for a commercial bus,ress) <br /> ' �(�S - �/�9`a�L �'i <br /> �}7'�__��_� �-1 �1 �_L . c�v �/_V/1 �-'��a rn z �� <br /> � Contraclor Ma�l Addre. Gty Slatel7.ip - - Pl+one i <br /> ����/.1Y�,�� (� (� _�S -7 S_S-�-- - � <br /> � WA State Coniractor I_icense Number(reqwretl) City of EvereU Business License Number(required) <br /> IWork to be done: <br /> ❑ Side 5ewer Repair � <br /> I <br /> I ❑ Side Sewer AlteraUon I <br /> ; <br /> ❑ Side Sewer - New Installatior� � <br /> � nstall [3ackwater Valve (outside the building) <br /> I <br /> � ❑ Cap of( Sewer <br /> ' i <br /> � � <br /> ❑ Install Water Meter - ---- — <br /> FFE <br /> ! � 30�� <br /> . <br /> --- --_- <br /> �_2O�I� PFRMIT# — -- ----- <br /> —. . _- - --- — <br /> 5�9n r � Date I I � G � r O(� <br /> lJ J 7 ' ( <br /> r is.r, ,,.,,i;r�, ' <br /> �_ _ . _ . . ___ .. ___—_' . _ . _ . .. _ . _—'_ _'._-___—__ _'__'._ .__ ..__ _—.__' __ <br />