Laserfiche WebLink
UTILITY PERM�T 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 />�23� H�T <br />PROJECT ADDRESS <br />MU y_�{.�r %�G/ � �Ci w k � r� _ <br />Property Owner r.1a�l ndd�ess C�ry <br />Tenanl Name 11( this �s for a commercial business) <br />/�//GI�G�I/�r^/3�/�� S�/G7 %I�/�✓GiyE <br />Contraelor I,ta��Atldress City <br />��c.i i, PL �3 GT <br />WA State Contractor License Number (reqwrco) <br />Work to be done: <br />❑ Side Sewer r�epair <br />❑ Side Sewer Alteration <br />❑ Side Sewer – New Installation <br />� Install Backwater Valve (outside the building) <br />❑ Cap off Sewer <br />❑ Install Water Meter <br />` s���,w�� — <br />;,. .,::.� <br />/ <br />Statc2�p <br />Phone <br />State/Zi0 Phone <br />GS.� �/ SS __ <br />City of Everelt Business License Number (required) <br />FEE <br />-�� o0 <br />� <br />� <br />PERM[T;. <br />U 1�03- D�5 <br />