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�TILITIE S <br />PERMIT NIIMBER U1610-016 <br />�oa A��aFss 2212 2l ST ST <br />DEscRiNnoN SIDE SEWER REPAIR <br />owNFa POLLOCK SUSAN <br />ZZ�ZZ�STST <br />PERMIT <br />�ITY OF EVERETT <br />PERMIT SERVICES <br />3200 CEDAR STRE�'1' <br />EVERETT, WA 98201 <br />(425) 257-8810 <br />DATE: I O�O%�2O 1 E) <br />�ecn� ��scxiPTioN CAPITOL HILL ADD BLK 441 D-O] <br />A�'N: 0040 1 544 1 03 1 0 1 <br />TENANT <br />EVERETT WA 98201-2412 <br />CON � �^� ��°� SOUTH WEST PLUMBING <br />2401 SW ALASKA ST <br />SEATTLE WA 98106 <br />i�iioNi: <br />PHONL- 2�6()32�777 <br />WATER SERVICE <br />$ERVICI-: SIZC I SERVICF. TYPE FRONTA(iE NO. OF UNITS SERVIC.E ORDER NO. APPLI('ATION �'O. <br />I �.�� <br />I I I <br />SETI'ER I\'STALLAllU1' DA"fL: <br />�IER�O. <br />R.F. NO. <br />YIETER ISTAI,I,ATION DA'TE <br />WATERON OFI� . LOCKEDOUT <br />REMARKS. <br />PLRMI-I' N(). <br />RE�IARKS: <br />INSPECTED BY <br />BY <br />SIZE <br />BY <br />ev <br />#I BACKFLOW' DEVICE SERIAL \'O. <br />#2 BACKFLOW UGVICE SERIAL h0. <br />MODEL NO. <br />SEWER SERVICE <br />_'f'1 i"' <br />TSG �T� .„„� iJ,; <br />,.a't <br />' ` ��� �wl <br />__i p <br />y '"{ :J'J <br />�. �i �'J I'Y-1 <br />'.T_ .r..' yoi <br />�"r-� _ _ <br />,� <br />�:� <br />: .._� .._�i <br />I__.. <br />S�-�69J5 PERMITTYPk: I LID�'O. . : <br />r�"I <br />Please �iote: The City is responsible for structural defects in the side sewcr on the City ROW side per F,VIC 14.�8z2'60 .,:.;:,. <br />_•A <br />� ��. ���i � <br />�� Oi •�� t <br />SEWER UI�ILITY FEE <br />TOTALFEES <br />$30.00 <br />$30.00 <br />FEES <br />DATE: / � � � / e_ <br />/ <br />PERMIT NUMBER U16]0-016 <br />ADDRESS COPY <br />