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BLD2021-0768_Application_6.7.2021_8.03.16_AM_2234425CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #973381 - PHILLIP HUGHES oil conversion Applicant First Name Last Name Company Name Al Namazi Energy Technologies Number Street Apartment or Suite Number E-mail Address 11809 NE 48th PL alnamazi@aol.com City State Zip Phone Number Extension Kirkland WA 98033 (425) 894-4115 Contractor Company Name ENERGY TECHNOLOGIES LLC Number Street Apartment or Suite Number 11809 NE 48th PL City State Zip Phone Number Extension Kirkland WA 98033 (425) 894-4115 State License Number License Expiration Date UBI # E-mail Address ENERGTL916K1 7/2/2021 F;Dgg1 879D alnamazi@aol.com Project Location Number Street Floor Number Suite or Room Number 19500 84TH AVE W City Zip Code County Parcel Number EDMONDS 98026 27041800310500 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 Matthew N & Natalie M Rasmussen Number Street Apartment or Suite Number 19500 84TH AVE W City State Zip EDMONDS WA 98026 Certification Statement - The applicant states: I certify that I am the owner of this property or the owner's authorized agent. If acting as an authorized agent, I further certify that I have full power and authority to file this application and to perform, on behalf of the owner, all acts required to enable the jurisdiction to process and review such application. I have furnished true and correct information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of work requires a licensed contractor to perform the work, the information will be provided prior to permit issuance. Date Submitted: 6/7/2021 Submitted By: Al Namazi Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #973381 - PHILLIP HUGHES oil conversion Project Contact Company Name: Energy Technologies Name: Al Namazi Email: alnamazi@aol.com Address: 11809 NE 48th PL Phone #: (425) 894-4115 Kirkland WA 98033 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Mechanical Project Name: PHILLIP HUGHES oil conversion Description of Work: remove the oil furnace and install Mitsubishi heat pump ductless system Project Details HVAC Systems Heat Pump Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) 2 remove and haul away the oil furnace and duct work. Install 2 Mitsubishi ductless heat pumps in place of the existing oil furnace. Page 2 of 2