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mom <br /> UTILITIES CITY OF EVERETT <br /> EVERETT PERMIT SERVICES <br /> WASHINGTON PERMIT <br /> 3200 CEDAR STREET <br /> EVERETT, WA 98201 <br /> (425)257-8810 <br /> PERMIT NUMBER U1904-042 DATE 2 5 APR 2019 <br /> JOB ADDRESS 4905 COLBY AVE LEGAL DESCRIPTION <br /> DESCRIPTION INSTALL BACKWATER VALVE APN: 00377500000200 <br /> OWNER BERG ERNEST L TENANT <br /> 4905 COLBY AVE <br /> CONTRACTOR AA PLUMBING LLC <br /> EVERETT WA 98203 <br /> 8611 VISTARAMA AVE <br /> EVERETT WA 98208 <br /> PHONE <br /> PHONE 4254890123 <br /> WATER SERVICE <br /> SERVICE SIZE SERVICE TYPE FRONTAGE NO.OF UNITS SII2VI(E ORDER NO APPLICATION NO <br /> 0.00 <br /> SETTER INSTALLATION DATE BY <br /> METER NO. SIZE #1 BACKFLOW DEVICE SERIAL NO. <br /> R.F.NO. #2 BACKFLOW DEVICE SERIAL NO. <br /> BRAND <br /> MODEL NO. <br /> METER ISTALLATION DATE BY <br /> WATER ON OFF_ LOCKED OUT BY TSG 7473 j <br /> REMARKS: -y---i KA <br /> 7 I-1:1 <br /> SEWER SERVICE <br /> PERMIT NO. PERMIT TYPE ALTERATION I LID NO. <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 /> �:�i•.�z rtl� <br /> INSPECTED BY: I DATE <br /> FEES <br /> SEWER UTlLI'T'Y FEE $30.00 <br /> TOTAL FEES $30.00 <br /> IPERMIT NUMBER U1904-042 <br /> ADDRESS COPY <br />