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TILITIES
<br />PERMIT
<br />PERMIT NUMBER U1607-015
<br />JOB ADDRESS 6504 EVERGREEN WAY
<br />nEscxirT�oN CAP OFF SEWER DUE TO DEMO (TAVERN)
<br />owrrEa ,IT MADISON
<br />PO BOX 31609
<br />SEATTLE WA 98203
<br />PIIONE 2066195555
<br />5[RVICE SIZE � SERVICE TYPE
<br />SETTER MSTALLATION DATE
<br />b1ETER NO.
<br />R.F. NO.
<br />BRAND
<br />METER ISTALLATION DATE gy
<br />WATER ON _ OFF _ LOCKED OUT BY
<br />REMARKS:
<br />[TY OF EVERETT
<br />PERMIT SERVICES
<br />3200 CEDAR STREET
<br />EVERETT, WA 98201
<br />(425) 257-8810
<br />I DATE: , _ l _ 1 �o
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<br />LEGAL DESCRIPTION BEVERLY HILLS DIV 3 BLK 000 D•
<br />APN: 00393000001500
<br />TENANT
<br />CONTRACTOR
<br />I PHONE
<br />WATER SERVICE
<br />FRONTAGE NO.OFUNITS
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<br />OLYMPIC GENERAL CONTRS LLC
<br />2110 MADISON ST
<br />EVERETT WA 98203
<br />4253170851
<br />I i!1 BACKFLOW DEVICE SERIAL NO.
<br />#2 BACKFLOW DEVICE SERIAL NO.
<br />MODEL NO.
<br />SEWER SERVICE
<br />SERVICL• ORDER NO. � APPLICATION NO.
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<br />PERMI7' NO. ���':��
<br />SP-16738 PERMITTYPH CAP OFF '^^+^y LIDNO.
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<br />REMARKS: Please Note: The City is responsible for structural defects in the side sewer on the G' ROW side er E. C
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<br />:NSPECTGDDY� I DATE:
<br />SEWER UTILITY FEE
<br />TOTAL FEES
<br />$10.00
<br />$10.00
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<br />PERMIT NUMBER U1607-015
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