Laserfiche WebLink
� � UTILITY PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.evereriwa.org <br /> � ICU �-r �v �tiy �� <br /> PROJECTADDRESS <br /> J�4-r�.�-L,r.� o2.c7 G l �S'o?� -� <br /> PropeRy Owner Mail Add`ass City � S�E[PJZip Phone <br /> Tenant Name(If Ihis is for a commercial business) <br /> ��OC':�1 ��Ue�i,�7iv�y/ 17 S� S �/I sr S,/- Sh` y+o�c.t�i't� L�I� �'l�Z�iTi �-/,2 S 7G,U fr 3GU <br /> Conlrador MallAddress City StotelLip Phone <br /> rv+Or�� P��.'- Sf�S 3 S U O 5 "'� (� 3 S <br /> WA State Contraclor License Number(requlred) City of Everett Business License Number(required) <br /> Work to be done: <br /> ❑ Side Sewer Repair <br /> ❑ Side Sewer Alteration <br /> ❑ Side Sewer— New Installation <br /> �t'Install Backwater Valve outside lhe building) <br /> ❑ Cap off Sewer <br /> O Install Water Meter <br /> Fl"E <br /> � 30 �� <br /> G�i� V � lO �-2 �' /S� PERMIT# <br /> Signoture �ate ���O <br /> � l lO� <br /> P.EVISED ti/1940IE <br />