Application_948167CITY OF EDMONDS MyBuildingPermit.com
Mechanical Application #948167
Applicant
First Name
Michael
Last Name
Rayborn
Company Name
Blueline HVAC
Number Street
4227 S Meridian
Apartment or Suite Number E-mail Address
#250 bluelineheat@gmail.com
City State
PUYALLUP WA
Zip
98373
Phone Number Extension
(253)444-9049
Contractor
Company Name
BLUE LINE HVAC
Number Street
s meridian
Apartment or Suite Number
City
Puyallup
State Zip
WA 98373
Phone Number Extension
(253) 444-9049 (253) 307-1161
State License Number
BLUELLH841 N2
License Expiration Date
8/22/2022
UBI # E-mail Address
BD4Dgfl5gD bluelineheat@gmail.com
Project Location
Number Street
1432 9TH AVE W
Floor Number Suite or Room Number
City
EDMONDS
Zip Code
98020
County Parcel Number
00608300000400
Associated Building Permit Number
Tenant Name
Additional Information (i.e. equipment location or special
instructions)_
Work Location
Property Owner
First Name
Pauline M
Last Name or Company Name
Tuengel
Number Street
1432 -9TH AVE N
Apartment or Suite Number
City
EDMONDS
State
WA
Zip
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: 4/12/2021 Submitted By: Michael Rayborn
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CITY OF EDMONDS MyBuildingPermit.com
Mechanical Application #948167
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)
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