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UTILITY PER�r�IT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STRL"ET, EVERETT, WA 98201 <br />425-7_57-8810 - FAX 425-257-8857 - wwv�.everettwa.org <br />3��� ��� �-V� <br />PROJECT ADDRESS <br />P�.,�� �-�. 1�4�`� 3� I� � <br />Property Ov+ner <br />Idail Address <br />Tenant Name Q( this is lor a cornmercial busmess) <br />CoNractor !.taJ.�cdress Crty <br />����� c�7�.7 <br />l^JA Slate Conlractor License Number (required) <br />Work to be done: <br />� Side Sewer Repair <br />❑ Side Sewer Alteration <br />❑ Side Sewer - New lnstallation <br />❑ Install Backwater Valve (outside the building) <br />❑ Cap off Sewer <br />❑ Install Water Meter <br />REVISeO I ll19?01J <br />C�ry <br />v���� �8�� <br />State2ip <br />Stale�2ip <br />2�3 �o �- <br />Phone <br />�. <br />Ciry of Everett Busmess License Num6er (re.�wred) <br />C7 j %� 5� <br />FEE <br />3�°� <br />PERMIT# <br />�l�k� � -�C�( <br />