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_ UTILITY PE��JIIT �4PPLIC�TION <br />CITY OF EVF.FZETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />�--�� �t-��� <br />PROJECT ADDRESS <br />V� � <br />Mail Address <br />Tenant Name (I( ihis is for a commercial business) <br />/I <br />�I <br />Contractor r,1a�Cgddress - city <br />�l� fa���,�Q <br />WA State CoMrac�or License Number (required) <br />Work to be done: <br />❑ Side Sewer Repair <br />❑ Side Sewer Alteration <br />❑ Side Sewer — New Installation <br />stall Backwater Valve (outside the building) <br />❑ Cap off Sewer <br />❑ Instail Water Meter <br />-�v ` <br />nrvr.;cn � in��.=r.��� <br />Gty <br />_ <br />Slale2ip <br />M'`. ��'7�`� �. <br />Sla�elZip Phone <br />IJiUliI9 <br />��� S S� <br />Cily of Everetl Business License Number (required) <br />r-FE <br />� ����� <br />�^ � S P[RMITIt <br />--I u 16D�-1 I� <br />. --... �-rr^;=-- - . . , ." , � - - <br />,�-- <br />' <br />� � �. �_ , . i,� ,... ��� .�.,,y.. ,,.�4� � Y ;...,. ',, � r + . �- . .._'%'. �,� -. . .. . � <br />� ..y..r_�.evr�_u..._._ " __. _.. .` _'r'_.�"_n...,_ <br />, _ . __. n:u.iii�__ <br />