Laserfiche WebLink
� <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 />�� l 25 .ti�����1 i r�-� <br />PROJECT ADDRESS <br />�`;'YC' -2. C���^ � Z I 2� tM C�� �i o, 1 I /�� �' v-<.� :4-�- �./�- G( �� G I <br />�� <br />Property Owner Mail Address City State/Zip Phone <br />Tenant Name (If this is for a commercial business) <br />�� �� (v(� }�,��i;v � � � ln�-� r�� � . ��� l 1� 1 ti� �v K I,J ► (c� �l �'s� � �S <br />Contractor Mail Address City State/Zip Phone <br />��T�C��L2�� <br />WA State Contractor License Number (required) <br />Work to be done: <br />�" Side Sewer Repair <br />�� <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/>9/2014 <br />� /s� <br />City of Everett Business License Number (required) <br />FEE <br />5��� <br />PERMIT# <br />�J � G�c�S - C> Z� <br />