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 />nab <br />PROJECT ADDRESS <br />Property Owner Mad Address <br />Tenant Name ;If this is for a commercial business) <br />eAu cew <br />Mail Address <br />t <br />amF2�5s lg KL <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 />r—U <br />City <br />StatelZip <br />I% <br />zs) <br />City State/Z6 Phone <br />CR Install Backwater Valve (outside the building) <br />❑ Cap off Sewer <br />❑ Install Water Meter <br />Phone <br />o352IR <br />City of Everett Business License Number (required) <br />L/ - 2Z - /S <br />FEE <br />A � 0. °i <br />PERMFI-# <br />U 156 111) <br />REWSED 1111912014 <br />