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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 />mC., <br />PROJECT ADDRESS <br />Property <br />Mail Address <br />Tenant Name (If this is for a commercial business) <br />4. e j 2(G06Lclellii d;z � �2 <br />Contractor Mail Address city <br />AM KTtb !=3(�) �, K � <br />WA State Contractor License Number (required) <br />Work to be done: <br />❑ Side Sewer Repair <br />❑ Side Sewer Alteration <br />❑ Side Sewer— New Installation <br />9/1 nstall Backwater Valve outside the building) <br />❑ Cap off Sewer <br />❑ Install Water Meter <br />( ZZ36) <br />q 12 - 51/8 <br />city State0l) Phone <br />(il 7s) <br />0Lo3 Z'gq'�-qC(�4 <br />statelzip Phone <br />!7 ':� `/ <br />City of Everett Business -icense Number (required) <br />4l-g--15 <br />FEE <br />U _/ <br />PERMIT# <br />NEVISED IIn9R01C <br />