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CITY OF EVERETT <br /> EVERETT Permit Services <br /> WASHINGTON <br /> CONTRACTORS AND SUBCONTRACTORS TO PERFORM WORK FOR UTILITY COMPANY: <br /> All Contractors and Subcontractors permitted to do work for the above-mentioned Utility Company must have <br /> a valid state contractor's license, a valid City of Everett Business License, and must be provided a copy of this <br /> Annual Blanket Utility Permit document for their use in adhering to the requirements herein. A list of all <br /> contractors and their representative signatures shall be completed below for acknowledgement of this <br /> requirement: <br /> CONTRACTOR 1: <br /> Contractor Company Name: <br /> State Contractor's License#: Expiration Date: <br /> City of Everett Business License#: Expiration Date: <br /> Contact Name/Email: <br /> Representative's Signature: Date: <br /> CONTRACTOR 2: <br /> Contractor Company Name: <br /> State Contractor's License#: , Expiration Date: <br /> City of Everett Business License#: , Expiration Date: <br /> Contact Name/Email: <br /> Representative's Signature: Date: <br /> CONTRACTOR 3: <br /> Contractor Company Name: <br /> State Contractor's License#: Expiration Date: <br /> City of Everett Business License#: Expiration Date: <br /> Contact Name/Email: <br /> Representative's Signature: Date: <br /> CONTRACTOR 4: <br /> Contractor Company Name: <br /> State Contractor's License#: , Expiration Date: <br /> City of Everett Business License#: , Expiration Date: <br /> Contact Name/Email: <br /> Representative's Signature: Date: <br /> Page 7 of 8 <br />