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Application_2021-0477CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #944630 Applicant First Name Last Name CM Heating Company Name C.M. Heating, Inc Number Street 1415 Broadway Apartment or Suite Number E-mail Address DEBBIE@CMHEATING.COM City State Zip Everett WA 98201 Phone Number Extension 4252596666 Contractor Company Name C M HEATING INC Number Street 1415 Broadway Apartment or Suite Number City State Zip Everett WA 98201 Phone Number Extension (425) 259-6666 State License Number License Expiration Date CMHEAI*095R4 5/3/2021 UBI # E-mail Address BD111465g DEBBIE@CMHEATING.COM Project Location Number Street 23706 101 ST AVE W Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00446700000400 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 Robert Strock Number Street 23706 101 ST AVE W Apartment or Suite Number City State EDMONDS WA Zip 98020-5759 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: 4/5/2021 Submitted By: CM Heating Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #944630 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, INSIDE Master Bath, Garage) Page 2 of 2