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UTUTY PENN APPUCAA00 N' <br /> UTY OF EVERETT PERNMT SERMES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> e'k <br /> PROJECT ADDRESS <br /> b Ile <br /> Property Owner Mail Address City State/Zip Phone <br /> Tenant Name(if this is for a commercial business) <br /> Contractor Mail Address City State/Zip Phone <br /> WA State Contractor License Number(required) City of Everett Business License Number(required) <br /> Work to be done: <br /> • Side Sewer Repair <br /> • Side Sewer Alteration <br /> • Side Sewer — New Installation <br /> 2XInstall Backwater Valve (outside the building) <br /> El Cap off Sewer <br /> 0 Install Water Meter <br /> FEE <br /> `2 — PERMIT# <br /> SignatureDa/k6 U 101 ( <br /> REVISED 1111912014 <br />