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iJ 1ILITIES C Y OF EVERETT <br /> PERMIT SERVICES <br /> E�' • PERMIT <br /> 3200 CEDAR STREGT <br /> EVERF,TT,WA 98201 <br /> (425)257-8810 <br /> PERMIT NUMBER U1611-050 �ATE �] �(f/ <br /> JOB ADDRESS 2130 CEDAR ST LGGAL DESCRIPTION M NN SOTA ADD BLK 447 D-00- : <br /> nEscRu�rioN INSTALL BACKWATER VALVE A�'N 00516444701700 <br /> owNFR WAGONER JERALD B T�:N^NT <br /> 2130 CEDAR ST <br /> coNrancTOR AA PLUMBING LLC <br /> EVERETT WA 98201-2533 g611 VISTARAMA AVE <br /> EVERETT WA 98208 <br /> PHONL <br /> �'������ 4254850123 <br /> WATER SERVICE <br /> SF,RVICF.SILF I SERVICE TYPE FRONTAGk: �O.OF UNITS SERVICE ORDER NO. APPLICA'fION t�0. <br /> I I �.QQ I <br /> SETTER I�i$TALLATIOV DAI'E BY <br /> �[ETER\O. S1ZE HI BACKFLOW DEVICE$ERIAL VO. __ <br /> R F.NO. #2 HACKFLOW DEVICE SERIAL NO. <br /> BRAND __ ____ MODEL NO. <br /> METCR ISTALI,ATIOM1 DATE HY <br /> WATERO� OPF _ _ LOCKHDOL'T BY _.__ TSG <br /> RHMARKS <br /> SEWER SERVICE <br /> PERMII'NO. SP-1 /OO6 PER""T��"'>" ALTERA'I'ION `�1°"0. <br /> REMARKS: Please Note:"I'he City is responsible for structural defects in the side sewer on the City ROW side per EMC 14.08.260 <br /> INSPECTED BY. I nATE: <br /> FEES <br /> SF..WI:R UfILITY FEt; $30.00 � �::a�� `�i �� � <br /> � p� 4� 7 4c <br /> IV�Y ' ,� <br /> � ! �QfU r <br /> / <br /> ``��Y OF �'V�R�?'�' <br /> ��.: <br /> ,t �,v�c� <br /> :� <br /> T07'Al.FEES $30.00 <br /> PERMIT NUMBER U1611-050 <br /> ADDRESS COPY <br />