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UTILITY PER�JIII� APPLICATION <br />CITY OF �VERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br />� � l,v.�7i-r� � � � v i , <br />PROJECT ADDRESS <br />Jc� SI.J�uh <br />930 l.���� nv� �����1 <br />PropeAy Owner Ma�l Address C�ly State2ip Phone <br />Tenant Name (If this is tor a commercial business) <br />�f�J S.El.✓�r� .� �7/lA A D-� � 6' •U . 760 �C SS.� -7� <br />�- . r- . <br />Co�lractor Mail Address <br />Nt�.S�GJ <br />WA State Contractor License Number (required) <br />Work to be done: <br />� we ei ed S r Repair <br />O Side Sewer Alteration <br />❑ Side Sewer — New Installation <br />Cily <br />❑ Install Backwater Valve (outside the building) <br />❑ Cap off Sewer <br />❑ Install Water Meter <br />FEVISEO H/19ROfa <br />�3/ StiP�g <br />,c� 9��.5'S - <br />Phone <br />�� � �� <br />Ciry of Everett Business License Number (required) <br />FEE <br />��0� <br />PERMff# <br />U (50 (- 0�5 <br />