Laserfiche WebLink
� <br />UTII .ITY PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STR[ET, EVERETT. WA 98201 <br />425-257-6810 - FAX 425-Z57-8857 —v,nvw.everetiv+a.org <br />�._G,� CGI[�ir <br />PROJECT AODRESS <br />O�:�ner <br />/U� <br />M1tai� AaCress <br />TenaM Name (If this �s tot a commercial busmess) <br />C�' /�G��G <br />Contractor <br />�i �GG /�l 9G3 G]� <br />4VA State Gonlrac orTL�cense NumOer (required) <br />Work to be done: <br />� Side Sewer Repair <br />� 5ide Sewer Alteration <br />O Side 5ewer — New instalialion <br />C�ty <br />�Install 8ackwater Valve (outside the building) <br />❑ Cap aff 5ewer <br />❑ Inslall Water Meter <br />/s rf�.�' <br />n�mSED irn9�C�� <br />Cdy <br />StateJZip <br />Sta1CIZ�R <br />Pnone <br />3f3'7 �So� <br />Phone <br />oS3� �/SS <br />Cdy ot Everett Business L+cense Num6er (require� <br />r-ee <br />.� 30. 0� <br />Pear�rru <br />U I 503 - 033 <br />