Laserfiche WebLink
UTILITY PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />��-C�s i ��� ��` <br />� <br />PROJECT ADDRESS <br />/V10�fie Ie�,;edX �✓es'�i� <br />Property Owner Mail Address Ciry <br />Tenant Name Qi this is (or a commercial business) <br />�2wer �: �� <br />Contractor �Mail Address <br />�S13�! S�tyF"eNf /i �li�d�'G <br />s��r fl ��6,�s <br />WA Stale Contracfor license Number (required) <br />Work to be done: <br />❑ Side Sewer Repair <br />❑ Side Sewer Alteration <br />Cily <br />❑ Side Sewer — New Installation <br />Install Backwater Valve (outside the building) <br />❑ Cap off Sewer <br />❑ Install Water Meter <br />r+evisen i visnoia <br />�/r4 9�Zo � u��; <br />State2ip Phone <br />Uf� �*2a�� �6_ <br />SlatelZip <br />Phonc <br />o �f�� � k <br />City of Everett Business License: Number (required) <br />Fre <br />�d0 <br />PERMiTJ/ <br />� I5o7= o� � <br />