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UTILITIES <br />PERMIT <br />PERMIT NUMBER U1603-054 <br />�o� nll�k�ss 1806 CEDAR ST <br />�rscKii>"r��N INSTALL BACKWATER VALVE <br />�wNi'.R RUIZ THEODORE & JACKS SAMANTHA <br />2320 139TH AVE SE <br />SNOHOMISH WA 98290 <br />CITY OF EVERETT <br />PERMIT SERVICES <br />3200 CEDAR STREET <br />EVERETT, WA 98201 <br />(425) 257-8810 <br />DATE: � � a�•- I �-(� <br />�scnL �FscRiPTioN NORMAN ADD TO EVERETT BLK <br />A�N: 00531300102700 <br />I'ENANT <br />coN��RncTOR AGOSTINO CONSTRUCTION INC <br />23418 SE 247TH CT <br />MAPLE VALLEY WA 98038 <br />PHONF <br />PHONL 4254338281 <br />WATER SERVICE <br />SERVI(�E tilLt <br />Stl'1'ER INSI'ALLATION DATE <br />SLR\'ICI; "I'YPL <br />NEl'ER NO <br />N.F NO <br />BRAND <br />METER ISTALLATION DATE BY <br />W.4TEN ON OFF LOCKED OL�T dY <br />ai;MnkKs. <br />I'1�12MI1' NO <br />RCMARKS: <br />INSPECTED BY� <br />fRON'1'AGE <br />NO. OF UNITS <br />�.�� <br />41 gACKYLOW DEVICE SERI.ALNO. <br />k2 BACK�LOW DEVICE SERIAL NO. <br />MODEL NO <br />SEWER SERVICE <br />TSG <br />SERVICE ORDER NO. I APPLICA'IION Nl) <br />SP-16593 '>"a""T'Y''` AL'fERATION I `1DNO <br />Please Note: The City is responsiblc for structurxl dcfccts in the side scwer on the City ROW side per ENIC 14.08.260 <br />Sewer Utiliry Fee <br />'I'OT1L FEES <br />FEES <br />$30.00 <br />�'0 POSTING � �IC1.1� <br />$30.00 <br />DATE'. <br />::�; c: a,.� 1'�.� '`;:;�; <br />�{�:� 2 R ?f!�� ! � ,: <br />PERMIT NUMBER U1603-054 <br />ADDRESS COPY <br />