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.everettwa.org <br />� � / � 1 � �-1 �I"l� <br />PROJECT ADDRESS <br />r < _ <br />Owner <br />ZLLt.� <br />Mad Adtlress <br />Tenant Name pl this is for a commercial business) <br />COf11f8C10f Mall Address <br />� drr�n <br />WA State oolraGor Ucense Number (reqWred) <br />Work to be done: <br />C� Side Sewer Repair <br />❑ Side 5ewer Alteration <br />❑ Side Sewer — New Installation <br />Cdy <br />nstall Backwater Valve (outside the building) <br />❑ Cap off Sewer <br />❑ Install Water Meter <br />nPviSrn t bl)^.0)1 <br />City <br />�r g � <br />S3�- <br />� 9 ,— 2�c�2- <br />Stale2lp Pnone <br />�� ya `� r <br />GIZ�� <br />SlalefZip Phone <br />os �--rs� <br />Gily of Everetl Dusiness License Numt�er (reqmred) <br />r-eE <br />�'�D.Qo <br />N�Rr�rru <br />U l � bt�-- D�� <br />