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�- -- -- -- <br />; UTILITY PERMIT APPLICATION <br />1 CITY OF EVERETT PERMIT SERVICES <br />( 3200 CEDAR STR[ET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 —vsNw.everettwa.org <br />�-Z� ! %�-Y�-n � <br />PROJEGT ADDRESS <br />\ I, .� c..r ;�t� �'I P_ 7i7�'( �(?�-�/1.� <br />Property Owncr <br />fda�l Address <br />Tenant Name (If this is for a commercial business) <br />: L��� � C9 <br />C�ry <br />State2ip <br />78 <br />Phone <br />Contractot Ma�lAddress �ny ","""•" � �--�-- <br />.�1�-�.��.��53� � K � h53 � �� <br />WA Stale CoMractor License Number (required) City of �verett Busmess License Number (required) <br />Work to be done: <br />❑ Side Sewer Repair <br />❑ Side Sewer Alteration <br />[-] Side Sewer — New Installation <br />0" Install Backwater Valve (outside the building) <br />❑ Cap off Sewer <br />❑ Install Water Meter <br />� � l - /S <br />FEvi5E0 �+i+cvo�a <br />FEE �� d� <br />URI 5� I- u y� � <br />