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Application_963648CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #963648 Applicant First Name Last Name Charity Teeters Company Name Advanced Installation Number Street PO BOX 1229 Apartment or Suite Number E-mail Address adv1 @advanced installation. net City State Zip CLINTON WA 98236 Phone Number Extension (425) 745-5977 Contractor Company Name ADVANCED INSTALLATION INC Number Street PO BOX 1229 Apartment or Suite Number City State Zip CLINTON WA 98236 Phone Number Extension (425) 745-5977 State License Number License Expiration Date ADVAN11033DU 3/13/2022 UBI # E-mail Address FD174gDq� adv1@advancedinstallation.net Project Location Number Street 9328 217TH ST SW Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00612900200100 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 Cynthia S Cook Number Street 9328 217TH ST SW Apartment or Suite Number City State EDMONDS 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: 5/14/2021 Submitted By: Charity Teeters Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #963648 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: 1st floor, Living Room Master Bath, Garage) Page 2 of 2