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 /> i� �� c� �►�d �► � Cwz�> <br /> PROJECT ADDRESS Ll-�-� <br /> f�� wa-xl� ��t�. c���� �v���Wa ���° � � � —� <br /> , <br /> Property Owner tdaii Address <br /> ��, 51ate2ip Phone <br /> l'l�dl C — <br /> Tenant Nane(Ii this is far a commercial business) <br /> (ti 2S� <br /> � S� �.G�' 1��1�� �!a CV��i� wa �t��o3 �.��.��as� <br /> Contractor Med ACdress <br /> Cih/ Slate2p Phone <br /> /� M�.�s �5 ��� ( K � ��3 ��(8 <br /> `NA Stale Contraclor License Number(reqwred) City of Everett Business Licanse Number(requued) <br /> Work to be done: <br /> p Side Sewer Repair <br /> p Side Sewer Alteration <br /> ❑ Side Se�ver- New Installation <br /> � � Install Backwater Valve outside the building) <br /> ❑ Cap off Sewer <br /> I <br /> ❑ Install Water Meter FEE <br /> ?��•� <br /> � —Z 3 ' Z��S PERMIT# <br /> Dalo I ' I �D I ' I ` � <br /> Sig al e v (/ <br /> rtEv�sen�insaor� <br />