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�� I ' 5 �Z�Lt _7 VS r <br /> UTILITIES CITY OF EVERETT <br /> EVERETT 7H^� PERMIT SERVICES <br /> WA S H I N G T O N PERMIT <br /> 3200 CEDAR STREET <br /> q?r 2✓ ems/ � EVERETT,WA 98201 <br /> j�— (425)257-8810 <br /> PERMIT NUMBER U2111-024 DATE <br /> JOB.ADDRESS 121 112TH ST SW BLDG B 9 8213 LEGAL DESCRIPTION <br /> DESCRIPTION WATER/FIRE METER ONLY/DCVA BLDG B APN: 28042400402100 <br /> OWNER UNITED METHODIST CHURCH OF EVERETT TENANT <br /> 2112 3RD AVE STE 300 CONTRACTOR NELSON&SONS CONST CO INC <br /> SEATTLE WA 98121 PO BOX 228 <br /> WOODINVILLE WA 98072 <br /> PHONE <br /> PHONE 4257703263 <br /> WATER SERVICE <br /> SERVICE SIZE SERVICE TYPE FRONTAGE NO OF UNITS SERVICE ORDER NO. APPLICATION NCI <br /> " DWI 0.00 SO-14748 APP-19727 <br /> SETTER INSTALLATION DATE n <br /> /''� BY <br /> METER NO.c(0l2.0V-kV3 SIZE 21' NI BACKFLOW DEVICE SERIAL NO. <br /> RF.NO. t S 1- Ct 5((�`QG N2 BACKFLOW DEVICE SERIAL NO. <br /> 4 <br /> BRAND IV f Y11 C- yy� /�J ('') MODEL NO. <br /> METER ISTALLAATION DATE E-I`{'ZZ BY APE <br /> WATER ON.J )FF_ LOCKED OUT_ , BY - TSG <br /> 2"DOMESTIC METER ONLY <br /> REMARKS' 3/4"DETECT METER ONLY FOR 4"FIRE SERVICE AND DCVA <br /> C" `Deq .es c U1'1 cy 11"-d ., <br /> SEWER SERVICE <br /> PERMIT NO. PERMITTYPE WATER-DOMESTIC 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 /> INSPECTED BY: I DATE <br /> FEES au.11eo <br /> PLUMBING FEES $35.00 �g <br /> WATER UTILITY FEE $1,655.00 NOV 29 2021. <br /> CITivOEV <br /> Permit Service <br /> TOTAL FEES . $1,690.00 <br /> PERMIT NUMBER U2111-024 <br /> UTILITY BILLING COPY <br />