Application_944233CITY OF EDMONDS MyBuildingPermit.com
Mechanical Application #944233
Applicant
First Name Last Name Company Name
greg percy hearthside and home Ilc
Number Street Apartment or Suite Number E-mail Address
4829 196th st sw d hearthsideandhome@yahoo.com
City State Zip Phone Number Extension
lynnwood WA 98036 4257716434
Contractor
Company Name
hearthside and home Ilc
Number Street Apartment or Suite Number
4829 196th st sw d
City State Zip Phone Number Extension
lynnwood WA 98036 (425) 771-6434
State License Number License Expiration Date UBI # E-mail Address
H EARTHL868BC 1 /3/2022 F;miq 15R 1 R hearthsideandhome@yahoo.com
Project Location
Number Street Floor Number Suite or Room Number
10101 232ND ST SW
City Zip Code County Parcel Number
EDMONDS 98020 00610700201402
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
Marlys D Mcdonald
Number Street Apartment or Suite Number
10101 232ND PL SW
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, 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: greg percy
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CITY OF EDMONDS MyBuildingPermit.com
Mechanical Application #944233
Project Type
Single Family Residential
Project Details
Appliances and Equipment
Gas Piping Outlets - Mech
Heaters
Fireplace Insert - Gas
Work Location
Activity Type Scope of Work
Alteration Mechanical
Work Description/Location (example: 1 st floor, Main floor living room masonry fireplace.
Master Bath, Garage)
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