Application_2021-0738CITY OF EDMONDS MyBuildingPermit.com
Mechanical Application #970568
Applicant
First Name Last Name Company Name
Michael Hasse
Number Street Apartment or Suite Number E-mail Address
773 mhasse@itwerx.net
City State Zip Phone Number Extension
Lynnwood WA 98046-0773 2065791722
Contractor
Company Name
Owner
Number Street Apartment or Suite Number
City State Zip Phone Number Extension
State License Number License Expiration Date UBI # E-mail Address
Project Location
Number Street Floor Number Suite or Room Number
24027 101 ST AVE W
City Zip Code County Parcel Number
EDMONDS 98020 00555000002500
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
Michael T & Chen Sz-Ying Hasse
Number Street Apartment or Suite Number
24027 101 ST AVE W
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: 5/31/2021 Submitted By: Michael Hasse
Page 1 of 2
CITY OF EDMONDS MyBuildingPermit.com
Mechanical Application #970568
Project Type Activity Type Scope of Work
Single Family Residential Repair or Replacement Mechanical
Project Details
Heaters
Heater - Gas
Work Location
Work Description/Location (example: 1 st floor, 1st Floor
Master Bath, Garage)
Page 2 of 2