10523 4TH DR SE 2016-08-31 - Laserfiche WebLink

P�FZMIi ,4F'PLICATION BUILL71�NiECa-IA�VLCAL I }��Ui!li�IR�G / SIGP�PFZI�E�CL.��i / DEIlI�C7L.1`iIOMlI C1TY OF EVERETT PERMIT SERVIZ�S 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@evereftwa.gov � www.everettwa.gov/permits >,. . .. : BUILDING Existinq Use of Buildinq: Proposed Use of Building: Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex Type of Project: ❑New ❑Addition ❑Remodel ❑Repair DESCRIPTION OF WORK: �y 5/�/ t a(� �(� �l � t� IASSOCIATED BUILDING PERMIT # (if applicable): x Contract Price of Work: Heat Source: ❑Gas ❑Multi-Family�# of Units: ❑T.I. ❑Siqn ❑5prinkler ❑Electric ❑Other ❑Commercial ❑Industrial ❑Demolition ❑Chanqe of Use PLUMBING PERMIT APPLICA710N ' . Type of Project: ,_New _Addn _Alteration _Repair Fixtures Lisf of Fixtures Fixtures ��sf of Fixtures Toilet Backflow Preventer (inside Sldg) Bathfub Urinal Lavatory (Wash Basin) Drinking Founfain Shower Floor Drain Kitchen Sink & Disposal Grease Trap Dishwasher Roof Drains Clothes Washer Medicaf Gas Water Heater Other: Sink (Service/Bar/Mop/etc.) Ofher: ACKNOWLEDGEMENT: 1 have �eviewed this application and confirm the information contained herein is true and correct. Work tlone pursuant to th�s perm�t musr compry w�rn cu��enf federal, state, and local la�v. The granting of a permif only authorizes approved work and no deviations theref�om. Deviations must first be authonzed in wrifing from the Bui/ding Official before being aufhorized under any circumstance. 1 am the owner, or l am authonzed Gy the owner of this property to perform the work for which application is made, and / comply with the Sfate Contractors Law 18.27�CW and 296200A WAC. Owner/Autho,r(zed Agent`Stg'nature Date Cify of Everett Official Use Only PERMIT �C I U� � , (Revised 90/92/?015J