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UTILITIES CITY OF EVERETT <br /> PERMIT SERVICES <br /> PERIVIIT" <br /> 3200 CEDAR STREET <br /> EVERETTWA 98201. <br /> (425)257 8810 <br /> (� <br /> PERMIT NUMBER ' U1810-012 DATEi 0 9 U cT, 1 2U 18 <br /> JOB ADDRESS 2912 NASSAU ST LEGAL DESCRIPTION • <br /> DESCRIPTION INSTALL BACKWATER VALVE ' " APN. 00437167703400 <br /> OWNER . HULTMAN LORRAINE D TENANT <br /> 626 WETMORE AVE CONTRACTOR _ AA PLUMBING LLC <br /> EVERETT WA 8611 VISTARAMAAVE <br /> EVERETI' WA 98208 <br /> PHONE <br /> PHONE 4254890123 <br /> WATER SERVICE I <br /> SERVICE SIZE-' -�.. . SERVICE TIDE FRONTAGE NO OF UNITS SERVICE ORDER.NO. APPLICATION NQ <br /> 0.00. I <br /> SEVER INSTALLATION DATE - BY - <br /> METER NO. SIZE :#1 BACKFLOW DEVICE-SERIALNO. - <br /> RF.NO. #2 BACKFLOW DEVICE SERIAL NO - - <br /> BRAND - :MODEL NOi <br /> ME-TER ISTALLATIONDATE. . .BY <br /> WATER ON_OFF_,.LOCKED OUT BY. TSG <br /> SEWER SERVICE I <br /> PERMIT NQ SP " <br /> -17850 P "'E ALTERATION LID NO. <br /> I I <br /> REMARKS: Please Note:The City is responsible for structural defects in the side sewer on the City ROW side per EMC 14.08.260, <br /> INSTALL BACKWATER VALVE <br /> • <br /> INSPECTED BY: I DATE- <br /> FEES <br /> ` I <br /> SEWER UTILITY FEE $30:00 a�. <br /> OCT 092018 <br /> C[TY OF EVERETT <br /> TOTALFEES $30.00 permit.Services <br /> PERMIT NUMBER U1810 012 <br /> I :. <br /> ADDRESS COPY <br />