Laserfiche WebLink
, <br />UTILITY PERMIT APPLICATION <br />CITY OF EVERETT PERMIi SERVICES <br />3200 CEDAR STREET, EVEREiT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />i�i�G 3s" sr <br />PROJECT ADDRESS <br />au/ //G <br />Property Owner <br />Mail Address <br />Tenant Name Q( ihis is (or a commercial business) <br />City <br />�h S% <br />Slate/Zip <br />Phone <br />/��p//G 7/u�+�3.r f SN�7 �/S�Ave,� E r�CtrYSv��ie ,,✓.4- ylsc,b (�/i.Si 3S7 /Soj <br />Conlraclor Mail Address City Slale/Zip Phone <br />fi�oii����� r <br />WA State Conlraclor License Number (required) <br />Work to be done: <br />❑ Side Sewer Repair <br />❑ Side Sewer Alteration <br />❑ Side Sewer — New Installation <br />'� Install Backwater Valve (outside the building) <br />❑ Cap off Sewer <br />O Install Water Meter <br />REVIS[O 11/f9R01a <br />�'l.S 3 �/.Sl <br />City o( Everett Business License Number (required) <br />FEE v o0 <br />� � <br />PERMIT# <br />U ( �b( -a�Z <br />