Laserfiche WebLink
�. `_, s { G��f�P�IY �4��'L.1C:��I I�i� <br />- ,�� �' �3111�,L�l�/ il��Ci-1�,1�9(��IL I i��.lJii�i�1�4� / S[�V�' �����I�1�C�...�� I ��:iili�l�l71�10�1 <br />��' CITY OF EVERETT PERMIT SER\� <br />+� -��� 3200 C6DAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@evereffwa.gov � www.everettwa.gov/permifs <br />I. . _- . <br />� <br />Existing Use of Building: <br />Proposed Use of Building: <br />Building Type: ❑SFR-Deiached ❑SFR Attached <br />Type of Project: ❑New ❑Addition ❑Remodel <br />DESCRIPTION OF WORK: <br />'�emou� --�1'Gim�ns� G'�onr� in„�(�,o�'� <br />�J <br />IAS50CIATED BUILDING PERMIT # (if applicable): <br />,DING. PERMiT. <br />Contract Price of Work: $ <br />Heat Source: ❑Gas ❑Electric ❑Other <br />❑Duplex ❑Muifi-Family�# of Units: ❑Commercial ❑Industrial <br />❑Repair ❑T.I. ❑Siqn ❑Sprinkler ❑Demolifion ❑Change of Use <br />���'M ��� � �zST�%�"� �Oi C'q (Q •� C�` I�� i n�.t,\ S�'+� <br />c� — <br />_ . .... <br />PLUMBING PERMIT.:APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Fixtures �-�st of Fixfures Fixtures List of Fixtures <br />Toilet Backflow Preventer (Inside Bldg) <br />Bathfub Urinal <br />Lavaiory (Wash Basin) Drinking Fountain <br />Shower Floor Drain <br />Kitchen Sink & Disposal Grease Trap <br />Dishwasher Roof Qrains <br />Cfothes Washer Medical Gas <br />Water Heater Other: <br />Sink (Service/BadMop/efc.) Other: <br />ACKNOWLEDGEMENT.� I have reviewed this application and contirm the information contained herein is true and co�rect. lNork done pursuant io this perm�t must comp�y wirn <br />cu�renf federal, state, and local law. The granting of a permif only authorizes approved v✓ork a�d no deviations therefrom. Deviations must fi�st Ge aufhonzed in v✓riting from the <br />Building Official 6efore being authorized under any circumstance. I am the owner, or f am authorized by the owner of this properfy to perform t1�e worlt fo� whrch application is made, <br />and / comply wifh the State Contractors Law 98.27 RCW and 296.200A WAC. <br />City of Evereti Offrcial Use Only <br />PERMIT # <br />r � �� ���.,��6 � - �� <br />d Agent Signafure <br />Date <br />(Revised 5/?_0/_09G) <br />��,�.;� d �' ��'Cry� <br />