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477 PERMIT APPLICATIOf` <br /> BUILDING / MECHANICAL/ PLUMBING / SIGN / SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue:or Black Ink°Only P>feAs ) PROJECT SITE INFORMATION , ..°; " , <br /> PROJECT SITE ADDRESS:6301 Elliott Way SE, Everett, WA 98203 PROPERTY TAX#:00392900801200 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> , ° 'CONTACT INFORMATION <br /> OWNER NAME: Popach Yuriy/ Darla TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: sTREET6011 Flemig St <br /> crrr Everett STATE WA zip 98203 <br /> OWNER PHONE: N/A OWNER EMAIL:N/A <br /> CONTRACTOR NAME:Popach Yuriy <br /> CONTRACTOR ADDRESS: STREET 6011 Fleming St <br /> „Tv Everett STATE WA Zip 98203 <br /> CONTRACTOR PHONE: N/A CONTRACTOR EMAIL: N/A <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) Drafter 1 4:10 1 <br /> CONTACT NAME: V CONTACT PHONE: °t 0 1 4 34'4 <br /> gliatifeettt "\IV L��pNEl CONTACT EMAIL: <br /> =, , ,., - BUILDJNG'INFORMATION, VKEt4C d .� exIn . <br /> Existing Use of Building: R-3 (residencial) Cj--i- 17—‘ Contract Price of Work:$$500.00 <br /> Proposed Use of Building: AFH Heat Source: P eas ❑Electric ❑Other <br /> BUILDING USE: EISFR ❑Townhouse ❑Duplex ❑ADU ElMulti-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑✓Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use/ <br /> , <br /> DESCRIPTION OF WORK: ✓ <br /> TO INSTALL GRAB BARS IN THE EXISTING TWO (2) BATHROOMS LOCATED ON THE LOWER LEVE. ZO� <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICALPERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fix es Count List of Fixtures Count Li f Fixtures <br /> A/C-Air Handling Units Gas Pip: g Backflow Preventer(Inside Bldg) Show , ub,or Combo <br /> Boiler Gas.'ange Clothes Washer • -Commercial(3-comp,prep,floor) <br /> Clothes Dryer -at Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> _Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Reside, ial) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air System Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/I :ert/Log Roof Drains Water Heater <br /> SPRINKL I.SOPPRESSIONSSYSTEM Sewage Er tor or Sump Pump Other: <br /> Water Suppression stemI No.of Heads <br /> Chemical Suppre -ion System No.of Heads <br /> ACKNOWLED EM- T:I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br /> current fed-al,stat and local law.The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building ►fficial be o e being a thorized under any circumstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and I co'ply with,th•State C. tractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> I PER # <br /> I Al r'2_. I .�0 3 " `J\ <br /> r` <br /> 0 7r/:ut rrize. Agent S 4 T Date (Revised 10/10/2018) <br /> 011 <br />