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UTILITIES CITY OF EVERETT <br /> PERMIT SERVICES <br /> En PERMIT 3200 CEDAR STREET <br /> EVERETT,WA 98201 <br /> (425)257-8810 <br /> PERMIT NUMBER U1603-078 DATE: 3 —-2 I W <br /> JOB ADDRESS 2509 19TH ST LEGAL DESCRIPTION CAPITAL HEIGHTS ADD TO EVER <br /> DESCRIPTION INSTALL BACKWATER VALVE Al N 00401435901000 <br /> OWNER BEMIS BYRON TENANT <br /> 2509 19TH ST CONTRACTOR AGOSTINO CONSTRUCTION INC <br /> EVERETT WA 98201 23418 SE 247TH CT <br /> MAPLE VALLEY WA 98038 <br /> PHONE <br /> PHONE 4254338281 <br /> WATER SERVICE <br /> SERVICE SIZE SERVICE TYPE FRONTAGE NO.OF UNITS SERVICE ORDER NO. APPLICATION NO. <br /> 0.00 I <br /> SETTER INSTALLATION DATE BY <br /> METER NO. _ _ _ _ _ _ SIZE #1 BACKFLOW DEVICE SERIAL NO. <br /> R.F.NO.__ _ I #2 BACKFLOW DEVICE SERIAL NO.__ <br /> BRAND_ MODEL NO. <br /> METER ISTALLATION DATE BY <br /> WATER ON OFF LOCKED OUT BY TSG <br /> v <br /> REMARKS. <br /> SEWER SERVICE <br /> PERMIT NU SP-16615 PERMIT TYPE ALTERATION 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 /> DATE: <br /> INSPECTED B1' <br /> FEES <br /> Sewer Utility Fee $30.00 <br /> TO POSTING s _ 25-1� MAR 2 8 2016 <br /> CITY OF UVCRETT <br /> Permit Services <br /> "TOTAL FEES $30.00 <br /> PERMIT NUMBER U 1603-078 <br /> ADDRESS COPY <br />