BLD2023-0722_Application_6.9.2023_9.36.34_AM_3587724CITY OF EDMONDS MyBuildingPermit.com
Mechanical Application #1327490 - KOEPKE 23-8004
Applicant
First Name Last Name Company Name
Christina Fritz Evergreen State Sheet Metal
Number Street Apartment or Suite Number E-mail Address
8431 Maltby Rd christina@essmwa.com
City State Zip Phone Number Extension
Snohomish WA 98296 (425) 252-3114
Contractor
Company Name
EVERGREEN STATE SHEET MTL INC
Number Street Apartment or Suite Number
8431 Maltby Rd
City State Zip Phone Number Extension
Snohomish WA 98296 (425) 252-3114
State License Number License Expiration Date UBI # E-mail Address
EVERGSS0220T 10/10/2023 5D1794.157 christina@essmwa.com
Project Location
Number Street Floor Number Suite or Room Number
24216 101 ST AVE W
City Zip Code County Parcel Number
EDMONDS 98020 00554900001100
Associated Building Permit Number Tenant Name
Additional Information (i.e. equipment location or special instructions)_
Work Location
Property Owner
First Name Last Name or Company Name
Dennis M Koepke
Number Street Apartment or Suite Number
24216 101 ST AVE W
City State Zip
EDMONDS WA 98020
Certification Statement - The applicant states:
I certify that I am the owner of this property or the owner's authorized agent. If acting as an authorized agent, I further certify that I have full power and
authority to file this application and to perform, on behalf of the owner, all acts required to enable the jurisdiction to process and review such application. I
have furnished true and correct information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of work
requires a licensed contractor to perform the work, the information will be provided prior to permit issuance.
Date Submitted: 6/9/2023 Submitted By: Christina Fritz
Page 1 of 2
i
CITY OF EDMONDS MyBuildingPermit.com
Mechanical Application #1327490 - KOEPKE 23-8004
Project Contact
Company Name: Evergreen State Sheet Metal
Name: Christina Fritz Email: christina@essmwa.com
Address: 8431 Maltby Rd Phone #: (425) 252-3114
Snohomish WA 98296
Project Type Activity Type
Single Family Residential Repair or Replacement
Project Name: KOEPKE 23-8004
Description of Work: install single zone ductless
Project Details
HVAC Systems
Heat Pump
Associated Building Permit?
There is no other onsite work that requires a building
permit.
Work Location
Work Description/Location (example: 1st floor,
Master Bath, Garage)
1
living room, side garden
Scope of Work
Mechanical
Page 2 of 2