9823 23RD AVE SE 79 2021-09-02 - Laserfiche WebLink

• PERMIT APPLICATION BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 l(E)everetteps@everettwa.gov www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: A27:1 7'irri AvP SE Fvprptt WA PROPERTY TAX#: nfPS71 nnnn7An LEGAL for new construction. Short Plat/subdivision Lot No (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Filizahpth F='I( TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET AR7'1 7Rrri AvP SF p` ci-v Everett STATE WA ZIP AR7n OWNER PHONE: d7 i- 7-nFi, OWNER EMAIL: CONTRACTOR NAME: Andgar Mechanical LLC CONTRACTOR ADDRESS: STREET 6920 Salashan Pkwy. A-102 PO Box 2708 crry Ferndale STATE WA ZIP 98248 CONTRACTOR PHONE: 360-366-9900 CONTRACTOR EMAIL: corporate@andgar.com CONTRACTOR LICENSE#(REQUIRED): ANDGAML825N3 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):24869 PRIMARY CONTACT: 0 OWNER gl CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 360-366-9900 (. •,1',w 2- 5 '363 Marla Raske / Dale Van Rooyen CONTACT EMAIL: corporate@andgar.com BUILDING PERMIT APPLICATION Existing Use of Building: Residential Contract Price of Work: $ 1000.00 Proposed Use of Building: Heat Source: ❑Gas DElectric DOther Building Type: ❑SFR-Detached DSFR-Attached ❑Duplex ❑Multi-Family-#of Units: OCommercial ❑Industrial Type of Project: ONew DAddition DRemodel DRepair ❑T.I ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Install Furnace Like In Kind ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub _ Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: AL SPRINKLER 11SUPPRESSI N :SYSTEM !Number of Heads ACKNOWLEDGEMENT.I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with current federal,state, 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 Building Official before being authorized 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, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only Marla J Raske ptgitallyske !!signed by Marla J 1 2/2 8/2 018 PERM 1� - la Ra Owner/Authorized Agent Signature Date (Revised 9/23/2016)