Laserfiche WebLink
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 />z�o8' Cl�.�e 1��� vQ <br />PROJECT ADDRESS <br />�'�N ('c5 �i�- Z�0 �i Gl2(,�..�f(� �� Lt�� `1�SZ�d l <br />Property Owner Mail Address City State/Zip Phone <br />Tenant Name (If this is for a commercial business) <br />�� <br />G��C% -�rx:�/ %c7 (, S.� Tv[�w' +/c, •I ivt� �Tv�C.J� Ij c� tvli— !�'' �ii (�; ,�"i �2 s• 7 2 3' 2 2 S <br />Contractor Mail Address City State/Zip Phone <br />1Z�� ��s� �22 � ,� <br />WA State Contractor License Number (required) <br />Work to b 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 />� Install Water Meter <br />re <br />REVISED 11/19/2014 <br />� <br />o37�z� <br />City of Everett Business License Number (required) <br />FEE <br />���,°.� <br />PERMIT# <br />U ( (� ( ( �" (�C�'! <br />