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.everE!atWa.org <br />3`ll6 �clf e�ei��/ - <br />PROJECT ADDRESS <br />rah,i?�ilfii?ct� <br />Property Owner Mad Address City Statelzip Phone <br />Tenant Name (If this is for a commercial business) <br />Contractor <br />Address <br />A Pa/ [ /'i �WZI <br />WA State Contractor License Number (required) <br />Work to be done: <br />❑ Side Sewer Repair <br />❑ Side Sewor Alteration <br />❑ Side Sewer — New Installation <br />City <br />plInstall Backwater Valve (outside the building) <br />❑ Cap off Sewer <br />❑ Install Water Meter <br />397 <br />27c /-5-- <br />Phone <br />o S39jss" <br />City of Everett Business License Number (required) <br />FEE <br />-30 00 <br />PERMIT# <br />U 0 (Sr72-c)4 <br />EEVISED 11/19QOli <br />