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U I'ILITIE S <br />PERMIT <br />PERMIT NUMBER U1611-019 <br />�oa ADvaaEss 1 1 10 B ROCKEFELLER AVE <br />DEsca�PTioN INSTALL BACKWATER VALVE <br />owr�ER EDWARDS JAMES D <br />2414 NE 60TH <br />SEATTLE WA 98115 <br />�TY OF EVERETT <br />PERMIT SERVICES <br />3200 CEDAR STREET <br />EVERETT, WA 98201 <br />425) 257-8810 <br />DA7 �: � � <br />LEcaL n�scRiPTioN HEIGHT ADD TO EVERETT BLK <br />^�'" 00468621902300 <br />�reNAN� <br />corvTrt.acTOK AA PLUMBING LLC <br />8611 VISTARAMA AVE <br />EVERETT WA 98208 <br />I PHONL I <br />PHONr 4254850123 <br />WATER SERVICE <br />SERVICL; SIZE I 5[RVICF TYPE FRO�ITAGE NO.OF IINITS SERVICE ORDER NO APPLICATION VO. <br />I I �.�� I I <br />SETTER MSTALLATION DATE <br />METER NO. <br />R.F. NO. <br />'vtETER ISTALLATION DATE <br />WATEROh' OF� LO('IiEDOUT <br />REMARKS. <br />P1:RM1T �'O. <br />REMARKS: <br />INSPECTED BY: <br />BY <br />BY <br />BY <br />I #I BACKFLOW DEVICE SERIAI,NO.-_ <br />#2 BACKFLOW DBVICE SERIAL NO. <br />;viODEL 'VO <br />SEWER SERVICE <br />TSG <br />SP-16977 PER411TTVPE �i PI p � TIO7�7 I LID VO. <br />L I 1�1\t1 1 1 lV <br />Please 1ote: The City is responsible for structural defects in the side sewer on the City ROW side per EMC 14.08.260 <br />SEWER UTILIT'Y FEE <br />TO"1'AI. I� EF,S <br />$30.00 <br />$30.00 <br />DATE: <br />�� � � <br />� <br />�'���� 1 7 2��6 <br />C'ITY �F �VER�7'�' <br />Permrt Services <br />PERMIT NUMBER U1611-019 <br />ADDRESSCOPY <br />