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. dd TT TT C FY OF EVERETT • <br /> I ll iITIE S <br /> PERMIT SERVICES <br /> r _„,, <br /> i : ,°: 3200 CEDAR STREET <br /> NN EVERETT,WA 98201 <br /> __, (425)257-8810 <br /> PERMIT NUMBER 111602-030 DATE: �• d. ---c., <br /> JOB ADDRESS 2102 SUMMIT AVE LEGAL DESCRIPTION ST NICHOLAS ADD BLK 454 D-00• <br /> DESCRIPTION SYSTEM DEVELOPMENT FEES FOR NEW DUPLEX APN: 00563245401700 <br /> OWNER GORDON HOMES LLC TENANT <br /> 9420 31ST AVE SE CONTRACTOR <br /> EVERETT WA 98208 GORDON HOMES <br /> 9420 31ST AVE SE <br /> EVERETT WA 98208 <br /> PHONE 4258761130 <br /> PHONE 4253384596 <br /> WATER SERVICE <br /> SERVICE SILL SERVICE TYPE I FRONTAGE <br /> I NO.OFUNITS SERVICE ORDER NO. APPLICATION NO. <br /> 0.00 I <br /> S1:11ERINSTALLATION DATE BY <br /> METERNO. SIZE #1 BACKFLOW DEVICE SERIAL NO. <br /> R.F.NO. • #2BACK FLOW DEVICE SERIAL NO. <br /> BRAND MODEL NO. <br /> METER.ISTALLATIONDATE BY f l. n'-_`°1 <br /> r, <br /> WATER ON OFF_ LOCKED OUT BY ,. K--•1--'1----1—. TSS-`F--i--* 1---• 'r <br /> K—= -`I'-''1---L 1""r` -r.''*,-i I <br /> —4 e <br /> a.,.a-r7`n-r_I:.U: CI.1 CXJ IT5_Cr.')Q T.'_? 1J <br /> aEMARlcs: one unit using 3/4"extg,other unit to have new 3/ _'k�er i :�� f rri —a r r,..rri r .:r_ <br /> a. =•i ces �rr D C-D C-s� :n <br /> rl _ri r-,-�,.e=a 1'*1 Pr'7 rl C,C+1 S C"1 <br /> r21 3ua Ll. moi <br /> r-1 f'',7 <br /> CTI C.a <br /> r. <br /> SEWER RVICE 11 I <br /> r•,:) <br /> PERMIT NO. SP-16529 PERMITTYPE ;DBEES _ I LID NO. I <br /> r.3 C=I <br /> REMARKS: Please Note:The City is responsible for structural defects ikl.?the sIRg ,"",t ul thEC,.$ r.RDU Sias calIV[41O�2 (il` -? <br /> •-i., Ca c-a Ca r_7-1 ND-1-•rid Sr.,i•J Cr.r'J L_a_t-•-h+CD!--• <br /> RECONNECT X2,ONE FOR EA DUPLEX UNIT.CONTR.TO VERIFY COND (31i, ,(� i�1� rI <br /> • L.J L.P4 Ca La Ca ra t^',�Ca Ca,:.J C,t:J,=a OD Ca C.a rTl n47: .. <br /> —I rJ Ca <br /> cs <br /> .INSPELI1D BY I DAT" <br /> FEES1 <br /> Sewer Utility Fee $130.00 <br /> System Development Fees $3,613.00 } <i <br /> Water Utility Fee $2,514.00 !°`} �'`" <br /> 1 <br /> TOTAL FEES $6,257.00 <br /> 1 PERMIT NUM13ER U1602-030 <br /> ADDRESS COPY r' 3 <br />