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� <br />UTIL.ITY 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 />5 � � � 2-� �� /�`1 ��(.� �; v�-�.�-�- <br />PROJECT ADDRESS <br />roperty Ow�er <br />Sc�n S I J 7 z� f� � <br />Mail Address City <br />Tenant Name (If this is for a commercial business) <br />� <br />Contractor Mail Address City <br />., , 2 ,� � <br />A State Contractor License Number (required) <br />Work to be done: <br />�l 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 />� / <br />,=�; ' ,_ . <br />REVISED 11/19/2014 <br />(� I; v�� �- vti/-� �� � <br />State/Zip Phone <br />�l� f�'����1� ��l//� I�Z7� <br />State/Zip Phone <br />���zy <br />City of Everett Business License Number (required) <br />FEE <br />�D- V� <br />PERMIT# <br />U L`�D�-��-� <br />