Laserfiche WebLink
UTILITY PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CED.4R STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />PROJECT ADDR�S� r—v� �( )� `P � <br />�, ? � C�1'y� � <br />,�,i �, �, . 1-�'D <br />P n.tvllv.�nr 1+7ai1 Address City <br />Tenant Name (If this is for a cammercial business) <br />�aTlls Q�����+�a �?a.s5�t� <br />Conlractor M11a�l Aderess ��Y <br />�'t�M�R�I�i �i MS <br />WA Slale Contrattor License Number (required) <br />Work to be,done: <br />Side Sewer Repair <br />❑ Side Sewer Alteration <br />O Side Sewer - New Installation <br />❑ Install Backwater Valve (outside the building) <br />❑ Cap off Sewer � <br />❑ Install Water Meter <br />:�..�' S. <br />CCiiiCF/1 �1/10(Mld <br />� <br />�J <br />Stale2ip - � Phone <br />� State/Zip . � � Phone <br />Oy7�0� <br />City of Everett Business License Number (required) <br />,'` <br />:- .� . <br />: FEE � <br />��, ✓ <br />; PERMIT#` <br />- U � 5 f��l -D35' <br />