4626 DARLINGTON LN 2017-11-28 - Laserfiche WebLink

• 4110 411SPERMIT 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 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:4626 Darlington Lane, Everett, WA 98203 PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: John Hastings TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 4626 Darlington Lane CITY Everett STATE WA ZIP 98203 OWNER PHONE: 425-347-4626 OWNER EMAIL: CONTRACTOR NAME: Andgar Corporation CONTRACTOR ADDRESS: STREET 6920 Salashan Pkwy.A-102 PO Box 2708 CITY Ferndale STATE WA ZIP 98248 CONTRACTOR PHONE: 360-366-9900 CONTRACTOR EMAIL: corporate@andgar.corn CONTRACTOR LICENSE#(REQUIRED): ANDGAC*19102 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):24869 PRIMARY CONTACT: ((7 OWNER 0 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 360-366-9900 Marla Raske / Dale Van Rooyen CONTACT EMAIL:corporate@andgar.com BUILDING PERMIT APPLICATION Existing Use of Building: Primary Residence Contract Price of Work: $4,641.00 Proposed Use of Building: Heat Source: ❑Gas ViElectric DOther Building Type: ruSFR-Detached ❑SFR-Attached ❑Duplex DMulti-Family-#of Units: DCommercial ❑Industrial Type of Project: DNew DAddition ORemodel DRepair DT.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Install Heat Pump 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 Fixtures List of Fixtures Fixtures List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures A/C—Air Handling Units 1 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: SPRINKLER/SUPPRESSION 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/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 Digitally signed by Marla J PERMIT Marla J Raske Ranke / (S. Marla Owner/Authorized Agent Signature Date (Revised 9/23/2016)