Laserfiche WebLink
._ _ _ - - -- - ----- - 1 <br /> UTILITY PERMIT APPLICATION ' <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425•257-8610 - FAX 425-257-8857 -www.everettwa.org <br /> i l� �. fLr,�C/ct� <br /> PROJECT ADDRESS <br /> G!✓c! T�C-�z <br /> Propedy Owner hlail Address City Slate2ip Phone <br /> Tenant Name Qf Ihis is for a commercial business) <br /> /���o//<i P/L+nR�nc .fi��7 7/�'�✓G,�r /''�t.r�Sv�liv w?-9kzc/ �`/z.5) 3�s7— �SoJ <br /> Conlractor G1ailAddress City State.�Zio Phone <br /> �4��ii nG �03 �r oS3 �/S.f <br /> WA State Conlractor License Number(required) City of Everett�usiness License Number(required) <br /> Work to be done: <br /> ❑ Side Sewer Repair <br /> ❑ Side Sewer Alteration <br /> i <br /> ❑ Side Sewer - New Installation <br /> �Install Backwater Valve (outside the building) <br /> ❑ Cap off Sewer <br /> ❑ Install Water Meter <br /> FEE <br /> 3obo <br /> lI ����Zc/f PERMIT# <br /> � Signalurc �a�e ' I 1 �f, r _ /�l� <br /> V { LJ � V <br /> r,n�iseo i u+s:^,�++ <br />