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UTILITY PERMIT APPLICATION <br />CITY OF EVERETT PERMiT SERVICES <br />3200 CEDAR STREET, EVEREiT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />37v ► (Lv���e,ll�/ <br />PROJECT ADDRESS <br />.�sf�� 37vi ,z��k� <br />Property Owner <br />Maii Address <br />Tenant Name Qf this is for a commercial business) <br />�`���n I�IU,�,��n/ 175�5'--/l`—' <br />CoNraclor �MadAtldress <br />r1, � u-, Pl��:- FS Ff 3 5 c� <br />WA Stale Contractor License Number (required) <br />Work to 6e done• <br />❑ Side Sewer Rep�'r <br />❑ Side Sewer Alteration <br />U Side Sewer — New Installation <br />l � <br />=wrt�{" t� /�6'�f� f� 3 I f�3'3(� <br />Cily � Stale2ip Phone <br />S�+oti�;.�'t� �-✓�� GIFr2y� y?S �c.c.�s �Go <br />City Slale2ip Phone <br />OS?�63 S <br />Ciry of Everett Business License Number (required) <br />� Install Backwater Valve (outside the building) <br />� Cap off Sewer <br />❑ Install Water Meter <br />�—�v-�s`� <br />REt7$EO 11/19QOli <br />FEE <br />� 30. vo <br />PERMIT# <br />U�50�1-151 <br />