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. . UTILITY P�RNiIT APPLICATION <br /> CITY OF EVERETT PERMIT SE.RVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www everettwa.org <br /> � 0 Z� (-��-c j ,��F <br /> PROJECTADDRESS <br /> ���� C�U�,( Itn-�_�� -�-,-� 3z� -�88� <br /> Property Owner � Mail A.ddress City � Statc�Zip Phone <br /> Tenanl Name (If this is(or a commercial 6usiness) <br /> ��r ".� �iil C EN�� �- 7��`4�Z � <br /> Confractor Ma�l Ad ress Clly Slate/Zip Phone <br /> � ,o��/qk-a�/� p _� S`7 S S� <br /> WA State ontractor License Number(required) City o(Everett Business License Number(required) <br /> Work to be done: <br /> ❑ Side Sewer Repair <br /> ❑ Side Sewer Alteration <br /> ❑ Side Sewer — New Installation <br /> nstall Eiackwater Valve (outside the building) <br /> ❑ Cap off Sewer <br /> ❑ Insiall Water Meter ---- -- <br /> r-e� <br /> ��o� <br /> �,� ��._� S.— _— --- <br /> PFRMITft <br /> Signalure �a�e � I� ol(�,— I�' �I <br /> �+ivit�Foiin•;vui.r �— - � � <br />