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City of Everett <br />Date <br />Fixtures <br />No. <br />Bath Tubs <br />Clvhes Washers <br />Dental Units <br />Dish Washers <br />Drinking Fountains <br />Floor Drains <br />Kitchen Sinks <br />Roof Drains— Rainleaders <br />Shower Baths <br />Service Sinks <br />Bar Sinl <br />Septic Tanks —Drain Fields <br />Sumps <br />Urinals <br />Water Closets <br />Water Heaters <br />Wash Basins <br />Laundry Trays <br />Food Disposals <br />TOTAL FIXTURES <br />Permit Fee $ - <br />Plumbing Permit 'i <br />1. <br />DEPARTMENT OF PUBLIC WORKS Inspection Division <br />Address_-3 <br />Owner_ <br />Plumber %l�t� ✓�-� __ _ <br />City of Everett, by- <br />. <br />—IMPORTANT NOTICE — <br />All work must conform to the requirement of the City of Everett Plumbing <br />Code. It shall be the responsibility of the permit holder to see that the City <br />Inspection Division is notified for inspection before covering. <br />This Permit shall expire by limitation and become null and void is rork <br />authorized hereon is not commenced within 60 days from date c.' issue or if <br />work so authorized is abandoned after commencement for a period of 180 days. <br />Remarks and Corrections:__ <br />Roughing In— Date ;L_9-6YInspector_..'& <br />Roughing In — Date Inspector <br />I <br />Final — Date Inspector <br />This Permit must be posted on Job before starting any Plumbing Work. <br />Permit N? 84 <br />/`N2Ca7C <br />