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City of Everett <br />Date.--,-- - __ <br />Fixtures No. <br />Bath Tubs <br />Clothes 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 Sinks <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 />i'OTAL FIXTURES <br />Permit Fee $ <br />Plumbing Permit <br />DEPARTMENT OF PUBLIC WORKS Inspection Division <br />Address_ <br />Owner_ s A •_ -- — - — <br />Plumber <br />City of Everett, by _ <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 if work <br />authorized hereon is not commenced within 60 days from date of issue or if <br />work so authorized is abandoned after commencement fora period of 180 days. <br />Remarks and Corrections: — <br />Roughing In—Datel"-XS'76 Inspector Il <br />Roughing In — Date_ Inspector <br />Final — Date Inspector <br />This Permit must be posted on Job before starting any Plumbing Work. <br />Permit �' r <br />