Laserfiche WebLink
� PERMIT APPLICATION � <br />BUILDING / MECHANICAL. / PLUMBING / SIGN / SP <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />P 425 257 8810 FAX 425-257-8857 �(E) everette s@everettwa gov � <br />RINKLER / DEMOLITION <br />� � _ _ � p www.everettwa.gov/permits <br />r �p <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Fi tu es List of Fixtures Fixtu es List of Fixtures <br />Toilet Backflcw f'reventer (Inside Bldg) <br />Bathtub Urinal <br />Lavatory (Wash Basin) Drinking Fountain <br />Shower Floor Drain <br />Kitchen Sink & Disposal Grease Trap <br />Dishwasher Roof Drains <br />Clothes Washer Medical Gas <br />Water Heater Other: <br />Sink (Service/Bar/Mop/etc.) Other: <br />ACKNOWI I!)Gf M�:N7: I have rr,viewed this application and confirm the information r,ontained herein is [rue and correcr. worK oone pursuanr ro �n�s pe�nm rnus� cur��N�y w���, <br />currr.nt leder�i, state. and local law. The g�anting of a permit only authorizes approved work and no deviations therefrom. Deviations must first be authorized in writing (rom the <br />Rudd�ny Ofhcial before being aufhor�zed under any circumstance. 1 am the owner, or 1 am authorized by the owner of this property to perform the work for which application is made, <br />and I comply wrth (hc Statr, Contractors Law 18.27 RCW and 296.200A WAC. <br />City of Everett Official Use Only <br />PERMIT # <br />���� z� � <br />OwnerlAuthorized gent Signature Date (Revised 9/23/2016) <br />