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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 />���` 2� ► ►� �e-�- f�►J� <br />PROJECT AODRESS <br />Property Uwner <br />h7atl Adtliess <br />Tenant Name�(If Ihis is for a commercial iness <br />-, � �o ��wx/��- <br />�dail Atldress <br />�ST �c_ ��:� <br />WA Sla�e Contractor License umber (reqwretl) <br />Work to be done: <br />� Side Sewer Repair <br />O Side Sewer Alteration <br />D Side Sewer — New Installation <br />Cay <br />l� Instali 13ackwater Valve (outside the building) <br />� <br />� Cap off Sewer <br />❑ Install Water Meter <br />neviSE� +visaora <br />Gty <br />� <br />Stel¢/Zip <br />Stale�Z�o <br />: <br />C�Z�'� <br />Phone <br />Phone <br />�.t�l� d � 31io��s <br />City of Evere t Busines License Numbcr (required) <br />FEE <br />J O� <br />PERMIT# <br />u i��3-o�-g <br />