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PERNIIT NUMBER U1602-03Z <br />IOB ADDRESS <br />Dssc�TTorr <br />• �Cyni�:� <br />UTILITIES <br />PERMIT <br />�302 RAIN�R AVE <br />INSTALL BACKWATER VALVE <br />VIVEIlZOS JASON <br />z� oz �.z�x AVE <br />EVERETT VJA 9820I-3123 <br />CONTRACTOR <br />CITY OF �VEIaET'I' <br />PElaMIT SERVICE� <br />3200 CEDAR STR�ET <br />EVERETT, WA 98201 <br />f42� 257-8810 <br />nnzE: 2/Sf2016 <br />CAPiTOL HILL ADD 2 BT.K �96.D-00 - L <br />�� 0o�o�6a96o3iao <br />AMERiCAN S�PTTC & STDE SWR LLC <br />2606 T;ARLIN DR <br />EVERETT WA 98203 . <br />� rxoxE 4252992406 � Pi�o� 4257897296 I <br />WATEIi SER'VICT� <br />�o.rracE I xo.oF�Mrrs <br />� <br />NOTE: A water backflow prevention and/or consultation is required regarding cross connection control for imgation services and <br />services 1" or Iazger. Call Tam Markham at (425} 257-8833. <br />PLEASE CALL (425) 257-8862 TWO TO THR�E WF:EKS PRIOT2 TO WANTING WATER SERVICE INSTALL�D. <br />r ... t .. �;.��i n���� <br />C!:i r::7: _,i�i <br />(r� �7 " <br />.l'__� �:.._ ��:1 . <br />SEWERPEI�TNO. SP-1E>S31 Y�RMr�'�E ALTERATION I LIDrro. <br />R�MARKS= Please Note: Tbc City is responsible for sfructural defecfs in the side sewer on fhe'City ROW side per �14IC 14.08.266 <br />INSpECTED BY: <br />DATL: <br />�"i S.�„� C7i I'-:J r(_a ,Y y[�_i„.] <br />Notify the Public Works Tnspector.(425� 257-8810 24 hours in advance to schedule an inspection. �� - -�:__�� ,: � <br />- `--�1 i"�_7 �v> <br />•.:� i <br />It is the applicant`s responsibility to insure adequate protection against sewer bacicflow if the structure is located in the combined sanitary/stonn.s�er <br />system. <br />FEES <br />- SewerUtilityFee <br />Toraz.r��s <br />34.00 <br />$30.40 <br />Permifs expire if work is nat commenced within 180 days or ccases for m ore ihan 180 days. <br />PERMIT NCTMBE�t U16U2-Q32 <br />� Applicant Copy <br />