Laserfiche WebLink
UTILITY PERMIT 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 />I %o MC1)k3-jw < <,l <br />PROJECT ADDRESS t, <br />JJ <br />2 tq, C�r u ri LL �4 10 MC' DCy,1 C Q 1! E <br />Property Owner Mail Address `� City StatelLp Phone <br />Tenant Name (If this is for a commercial business) - <br />%i-bWI�.J�I <br />�P�IIG S (clE SC'1JP42C�flJr a D2, �C`Vt 4R'�n3 ?��L/—�(�P <br />Mad Address <br />r <br />SSA (Z1� <br />WA Slate Conlractor License Number (required) <br />Work to be done: <br />❑ Side Sewer Repair <br />❑ Side Sewer Alteration <br />❑ Side Sevver — New Installation <br />City <br />D Install Backwater Valve (outside the building) <br />❑ Cap off Sewer <br />❑ Install Water Meter <br />CgZ.S) <br />,7e.2At 2-52_-u401 <br />State/Zip <br />Phone <br />U-5-35-�,�-S <br />City of E%erelt Business License Number (required) <br />FEE <br />.�� 06 <br />PERMIT11 <br />U ICjd(-D�`� <br />REVISED 1111912014 <br />