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Application_2021-0471CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #944174 Applicant First Name Last Name Karen Matheney Company Name Washington Energy Services Company, LLC Number Street 3909 196th St SW Apartment or Suite Number E-mail Address permits@washingtonenergy.com City State Zip Lynnwood WA 98036 Phone Number Extension 2063786648 Contractor Company Name WASHINGTON ENERGY SVCS CO LLC Number Street 3909 196th St SW Apartment or Suite Number City State Zip Lynnwood WA 98036 Phone Number Extension (206) 378-6648 State License Number License Expiration Date WASHIES851 NS 9/7/2021 UBI # E-mail Address F;ni..r;99n 9 permits@washingtonenergy.com Project Location Number Street 21307 PIONEER WAY Floor Number Suite or Room Number City Zip Code EDMONDS 98026 County Parcel Number 00649900000500 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 Amy C & Crossman Ryan J Allison Number Street 21307 PIONEER WAY Apartment or Suite Number City State EDMONDS 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: 4/2/2021 Submitted By: Karen Matheney Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #944174 Project Type Activity Type Scope of Work Single Family Residential Alteration Mechanical Project Details Heaters Fireplace Insert - Gas Work Location Work Description/Location (example: 1 st floor, 1ST FLOOR Master Bath, Garage) Page 2 of 2