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� <br />UTILITY PFRMIT APRLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEREIT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 —www.everelt�va.org <br />� �CJ�d �U CL� <br />�Id g�°°"9`�ay ,�' - <br />PROJECT ADDRESS <br />�r�-y l�tuY�',y �ln � l. Rn�„��� i � <br />Property Owner <br />Mail Address <br />Tenant Name Qf ihis is for a commercial business) <br />City <br />bx �IeS-f-�r�, �-� ��23 a�6-'�s+5w f��u� <br />Contractor A �I Address � City <br />�s�1ss g'����� <br />W� Slate Contraclor Licens J nber (required) <br />Work to be done: <br />❑ Side Sewer Repair <br />❑ Side Sewer Alteration <br />❑ Side Sewer — New Installation <br />Ld' Install Backwater Valve (outside the building) <br />❑ Cap off Sewer <br />O Install Water Meter <br />,,,�:�,�,,;,�,:,�,. <br />��e <br />� <br />�/�S e <br />��` <br />Phone <br />ab� � <br />gv�� y6,�. <br />ylq3 <br />� Phonc <br />�s��_ a� <br />City ot [vcrctl Business Licensc Number (required) <br />FE[ <br />�� °° <br />�r�FRr�rrs <br />u i�v��o�(�� <br />