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Application_941702CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #941702 Applicant First Name Rich Last Name Vulliet Company Name Energy Works Number Street 7034 220th St SW Apartment or Suite Number E-mail Address info@energyworksnw.com City State Mountlake Terrace WA Zip 98043 Phone Number Extension (425) 409-5661 Contractor Company Name ENERGY WORKS LLC Number Street 7034 220th St SW Apartment or Suite Number City Mountlake Terrace State Zip WA 98043 Phone Number Extension (425) 409-5661 State License Number ENERGWL88OKS License Expiration Date 5/14/2022 UBI # E-mail Address F;nign4597 info@energyworksnw.com Project Location Number Street 23449 75TH AVE W Floor Number Suite or Room Number City EDMONDS Zip Code 98026 County Parcel Number 00488800300504 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Joseph & Nancy Last Name or Company Name Byers Number Street 23449 75TH AVE W Apartment or Suite Number City EDMONDS State WA Zip 98026 Certification Statement - The applicant states: I certify that I am the owner of this property or the owner's authorized agent, including an appropriately licensed contractor. I have furnished true and correct information. I will comply with all provisions of law and ordinances governing this type of construction work, whether specific herein or not. By submitting this application I give the jurisdiction permission to enter the property to perform inspections. I understand that failure to comply with the above may result in revocation of the permit. Date Submitted: 3/29/2021 Submitted By: Rich Vulliet Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #941702 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Mechanical Project Details HVAC Systems Furnace Work Location Work Description/Location (example: 1st floor, Garage Master Bath, Garage) Page 2 of 2