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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 everetlwa.org <br />3 70 7 e.6ei/cl- <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />Tenant Name (If this is for a commercial business) <br />Contractor Mad Address City <br />WA State Contr.-tor License Number (required) <br />Work to be done: <br />❑ Side Sewer Repair <br />❑ Side Sewer Alteration <br />❑ lide Sewer - New Installation <br />Install Backwater Valve (outside the building) <br />❑ Cap off Sewer <br />❑ Install Water Meter <br />City <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />PA <br />G S3 �/SS <br />City of Everett Business License Number (required) <br />AE V,SCO t rn9.Q0u <br />