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Application_2021-0450CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #942175 Applicant First Name Last Name Company Name CM Heating C.M. Heating, Inc Number Street Apartment or Suite Number E-mail Address 1415 Broadway kailana@cmheating.com City State Zip Phone Number Extension Everett WA 98201 4252596666 Contractor Company Name C M HEATING INC Number Street Apartment or Suite Number 1415 Broadway City State Zip Phone Number Extension Everett WA 98201 (425) 259-6666 State License Number License Expiration Date UBI # E-mail Address CMHEAI*095R4 5/3/2021 FD1 1 1465g kailana@cmheating.com Project Location Number Street Floor Number Suite or Room Number 18912 OLYMPIC VIEW DR City Zip Code County Parcel Number EDMONDS 98020 27031300401800 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 Harris Teresa M Sifferman Number Street Apartment or Suite Number 18912 OLYMPIC VIEW DR City State Zip EDMONDS WA 98020-2353 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: 3/30/2021 Submitted By: CM Heating Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #942175 Project Type Single Family Residential Project Details Heaters Fireplace Insert - Gas Work Location Activity Type Repair or Replacement Work Description/Location (example: 1st floor, LIVING AREA Master Bath, Garage) Scope of Work Mechanical Page 2 of 2