Laserfiche WebLink
r <br /> UTILITY PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257=8810 - FAX 425-257-8857 —www.everettwa.org <br /> PROJECT ADDRESS <br /> Property Owner Mail Address City State/Zip Phone <br /> n 0 So -Lo <br /> Tenant Name(If this is for a commercial business) <br /> Contractor Mail Address City State/Zip Phone <br /> ,zq i t 1�. 2�G � t1�. L- t-131-� 15 <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 Alteration <br /> ❑ Side Sewer— New Installation <br /> ®'Plnstall Backwater Valve (outside the building) <br /> ❑ Cap off Sewer <br /> ❑ Install Water Meter FEE <br /> 4�n. ° <br /> PERMIT# <br /> Sig at a Date U <br /> REVISED 1111912014 <br />