Laserfiche WebLink
May 18 2015 0335PM G'S PLUNBING 8 SERVICE 360691�1301 page 1 <br /> . --�Y�_�'�c�-' —y``-}„'. <br /> UTILITY PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257•8657 —w�w�.everettwa.org <br /> b� Co � <br /> PROJECTADDRESS <br /> �.��e,k ��.�� I l�c� C���„ /� �c��. (��- <br /> PfopC�ty Ownet A4ail Addre SlalelZlp Phone <br /> Tenant Namo(I(fhis Is for a cemmercial b.:sinoss) �h (1,��� S� <br /> ��n lI <br /> n;�<< �iU„�;.�,P4���a �c.��c-a��►. r� �a�. ��� �a-���Y <br /> CcNraclor ilAad:ase Ciy Swta2ip Phone <br /> ��S Q�.,pg � 1 S' ��� � �-1� �'0'7 <br /> WA State Conlrador License�Vumber(required) Cily of Evered Business Llcense Number(requirod) <br /> Work to be done; <br /> ❑ Side Sewer Repalr <br /> ❑ Side Sewer Alteration <br /> ❑ Side Sewer— New Installation <br /> ��tall Backwater Valve outside the building) <br /> ❑ Cap off Sewer <br /> ❑ Install Water Meter <br /> FEE <br /> � (y`� , <br /> � 3D,QO <br /> i <br /> _` ` I 0 ` � PERMCT# <br /> SignatUre DBIe � I� oj_ ,�I��� <br /> �/ l/ <br /> A[L'S[J t rnf;pra <br />