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• <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 /> 1.3oz, cascade, D e. . <br /> PROJECT ADDRESS <br /> Property Owner Mail Address City State/Zip Phone <br /> pe,c4( <br /> Tenant Namecpt,rii-vin <br /> this is for a commercial business) <br /> 7441.7 1 <br /> i. -Aeiz% /O 6 SS 7-,-,44,/I/4 b1ix, 77.4.4,/f11 k_ 1,14— r8/6A 4/25 - 77 7.-2Z5-7 <br /> Contractor Mail Address City State/Zip Phone <br /> Tet, 44R-SC- /228R. 037' 2.4/ <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 /> ❑ Install Backwater Valve (outside the building) 6 <br /> ❑ Cap off Sewer <br /> ❑ Install Water Meter <br /> FEE <br /> ------) <br /> 7 PERMIT# <br /> Signature ------7-/t/ V D e U ((010- — D t 0 <br /> REVISED 11/19/2014 t <br />