Laserfiche WebLink
UTILITY PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ?...�Q -{s <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org U � 507-��� <br /> I oL � g (T ra,vo �U� <br /> PROJECT ADDRESS <br /> S➢`���r�l�i� �va�h�.-�v <br /> PropeAy Owner Mail�ddress City StatefZip Phone <br /> Tenant Name (If Ihis is for a commerciai business) <br /> Ca� /J/>c�/S- /�/�r.h �o ,-,vy <br /> Coniractor Mail Address Clry SlatelZip Phone <br /> c�.l��o�i ��� �,� 9�� D y�� �Q3 <br /> WA Stale Contraclor License Number(required) 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 /> � Install Backwater Valve (outside the building) <br /> I <br /> ❑ Cap ofi Sewer , <br /> ❑ Install Water Meter - <br /> FFE <br /> � v 0�} <br /> i � <br /> �.���-� � %��� _ __ <br /> PeRr�rrr. <br /> S�9nalure �a� 1 1 I /'�,O"j �/.��t� <br /> i� � � � � <br /> ,����;,:,��„��.�a�� <br />