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-,. <br />CJTILIT�' PERMII' APPILICATION <br />CITI( �F `EVERETT PERMIT SE'RViCES <br />3200 GEDAR STREET, EVERETT, WA'98201 ` <br />425-257=8810 - FAX 425-257-8857 — www.everettwa.org <br />p � � � <br />_��,�'� <br />PROJECT ADDRESS <br />Property <br />Mail Address <br />It'�i � G�, � <br />Tenant Name (If this is for a commercial business) <br />City <br />State/Zip <br />� <br />� <br />Phone <br />,`;� ��C��-> �.-�t��<�� ��� %U'%�`�Lt `Lp,.� � �1���� (Lr,z.."� t�-�-c�-c�� � <br />ContraCtor Mail Address City StatelZip Phone <br />y,� l �`�'�= �.. � ��� ��� � � `I.--- � ".� � `� � � <br />WA State Contractor License Number (required) City of Everett Business License Number (required) <br />Work to be done: <br />❑ Side Sewer Repair <br />❑ Side Sewer Afteration <br />� Side Sewer — New Installation <br />�nstall Backwater Valve (outside the building) <br />❑ Cap off Sewer <br />❑ Install Water Meter <br />-._____._, <br />�, <br />REVISED 11/19/2014 <br />�`�� �` `��% <br />FEE <br />� �� ,�� <br />PERMIT# <br />� ��02- ���1 <br />