Laserfiche WebLink
, <br /> - � UTILITY PERMIT APPLICATIO�I <br /> CITY. OF EVERETT PERMIT SERVICES <br /> 3�OQ CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> 2v f 8 C� y� �v P �ver-e��4 <br /> PROJECT ADDRESS � <br /> G ra+^� � ss2ri <br /> PropertyOwner MailAddress � City Slate/Zip Phone <br /> Tenant Name (I(Ihis is for a commercial business) <br /> ���_�lls Qlu��«►a �Po. �S�� E�.�-�� �� q�� <br /> Contractor Mail Address C�ty StatelZip Phone <br /> C'A►'�'lr'R� �9 ►� MS oy77n3 <br /> VJA Stale CoNractor License Number(required) . City o(Everelt Business License Number(required) <br /> Work to be done: <br /> ❑ Side Sewer Repair <br /> ❑ Side Sewer Alteration <br /> ❑ Side Sewer - New Installation <br /> O I�II Backwater Valve (outside the building) <br /> ❑ Cap off Sewer <br /> ❑ Install Water Meter <br /> FEE <br /> � ��.�.� <br /> `�� ��G/w�v-!' S /2 Zp PERMiT# <br /> Signature / Date � I �O�I��` <br /> ��_�s <br /> REVISEU 11p9R01< � <br />