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10627 19TH AVE SE COOLEY SMILES DENTISTRY 2018-10-09
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10627 19TH AVE SE COOLEY SMILES DENTISTRY 2018-10-09
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Last modified
10/9/2018 8:18:22 AM
Creation date
7/20/2018 7:40:03 AM
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Address Document
Street Name
19TH AVE SE
Street Number
10627
Tenant Name
COOLEY SMILES DENTISTRY
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UTILITIES CITY OF EVERETT <br /> PERMIT SERVICES <br /> ,tigap"IIP'4i:;71A PENT 3200 CEDAR STREET <br /> EVERETT,WA 98201 <br /> wk Nz d�J3 (425)257-8810 <br /> PERMIT NUMBER U1712-005 DATE: <br /> JOB ADDRESS 10627 19TH AVE SE LEGAL DESCRIPTION <br /> DESCRIPTION 1" DOMESTIC WATER, SEWER CONNECTION-COOLEY SMI APN: 00445600003100 <br /> OWNER EPC HOLDINGS 908 LLC TENANT COOLEY SMILES <br /> 2001 WESTERN AVE SUITE 330 CONTRACTOR CONSTANTINE BUILDERS INC <br /> SEATTLE WA 98121 18486 BALLINGER WAY NE <br /> LAKE CITY WAY WA 98155 <br /> PHONE <br /> PHONE 4254857500 <br /> I WATER SERVICE I <br /> SERVICE SIZE SERVICE TYPE FRONTAGEI NO.OF UNITS SERVICE ORDER NO. APPLICATION NO. <br /> I" Jy DOM/FI 0.00 SO-14187 APP-19176 <br /> SE I l ER INSTALLATION DATE 5/ _-2-�+Q_/8 BY �/'k 4----METER NO. Sy /CO2- 2-L SIZE / 11 <br /> y tJ #1 BACKFLOW DEVICE SERIAL NO. <br /> R.F.NO.t 514E 16 5 L L/2— #2 BACKFLOW DEVICE SERIAL NO. <br /> BRAND /Ve_p1-t..3-2,E3 <br /> v-Q-�-6 MODEL NO. <br /> METER ISTALLATION DATE J-Z l G BY 1;74C• <br /> WATER ON_ OFF k LOCKED OUT BY TSG <br /> 1"DOMESTIC SERVICE <br /> REMARKS: <br /> ISEWER SERVICE I <br /> PERMIT NO. <br /> SP-17543 PERMIT TYPE NEW CONNECTION LID NO. I <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 /> NEW CONNECTION <br /> INSPECTED BY: I DATE: <br /> FEES p Z\\ I uI I <br /> — � <br /> SEWER UTll.ITY FEE $70,00 p <br /> WATER UTILITY FEE $2,900.00 DEC 2 8 2017 gid-, <br /> CITY OF EVERETT <br /> Permit Services <br /> TOTAL FEES $2,970.00 <br /> IPERMIT NUMBER U1712-005 I <br /> UTILITIES COPY <br />
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