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UTILITIES CITY OF EVERETT <br /> PERMIT SERVICES <br /> (i4L PERMIT <br /> 3200 CEDAR STREET <br /> EVERETT,WA 98201 <br /> & (425)257-8810 <br /> PERMIT NUMBER U1606-030 DATE: <br /> JOB ADDRESS 12615 16TH AVE SE LOT 5 LEGAL DESCRIPTION <br /> DESCRIPTION NEW 3/4"COMPLETE WATER SERVICE APN <br /> OWNER PACIFIC HEIGHTS HMS LLC TENANT <br /> 620 SE EVRT MALL WAY#350 CONTRACTOR <br /> EVERETT WA 98208-4950 <br /> PHONE <br /> PHONE <br /> WATER SERVICE <br /> SERVICE SIZE SERVICE TYPE FRONTAGE I NO.OF 0.00 I SERVICE ORDER NO. APPLICATION N0. <br /> SEITER INSTALLATION DATE& 5'/(' BY );, 44 <br /> METER NO. 4P 17✓j�7 2 5-9 SIZE / 11 BACKFLOW DEVICE SERIAL.NO. <br /> R.RNO. � BACKFLOW <br /> q2 BACKFLO <br /> W DEVICE SERIAL <br /> BRAND MODELNO. <br /> METER ISTALLATION DATEj j� 1111111111111111111111014 <br /> �• BY ��� 7 <br /> III II III IIII I IIII IIII I ill 1111 <br /> U <br /> WATER ON� OFF__ LOCKED OUT BY /'{OA— �• 1541515784 'ISG/ <br /> REMARKS: NEW 3/4"COMPLETE WATER SERVICE ED2B11 RWF3 <br /> 5/8"x 3/4" <br /> 69337259 <br /> I IIII I I I I II II IIII VIII VIII IIII IIII <br /> PERMITNO. PERMIT TYPE NEW CONNECTION 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 /> I V SPECTED BY: <br /> DATE_ <br /> FEES <br /> Water Utility Fee $2,514.00 ` <br /> ry <br /> JUN 13 2616 ' <br /> CITY' OF EVERETT <br /> TOTAL FEES $2,514.00 Perm i1 Services <br /> PERMIT NUMBER 01606-030 <br /> UTILITIES COPY <br />