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BLD2021-0822_Application_6.15.2021_8.55.23_AM_2249882CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #977751 - 555 4th Ave S Applicant First Name Last Name Company Name Karen Matheney Washington Energy Services Company, LLC Number Street Apartment or Suite Number E-mail Address 3909 196th St SW permits@washingtonenergy.com City State Zip Phone Number Extension Lynnwood WA 98036 2063786648 Contractor Company Name WASHINGTON ENERGY SVCS CO LLC Number Street Apartment or Suite Number 3909 196th St SW City State Zip Phone Number Extension Lynnwood WA 98036 (206) 378-6648 State License Number License Expiration Date UBI # E-mail Address WASHIES851 NS 9/7/2021 Fini.r;97ni9 permits@washingtonenergy.com Project Location Number Street Floor Number Suite or Room Number 555 4TH AVE S City Zip Code County Parcel Number EDMONDS 98020 00409600200600 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 Linda M Wilson Number Street Apartment or Suite Number 555 4TH AVE S 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. 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: 6/15/2021 Submitted By: Karen Matheney Page 1 of 2 CITY OF EDMONDS M BuildingPermit.com Mechanical Application #977751 - 555 4th Ave S Project Contact Company Name: Washington Energy Services Company, LLC Name: Karen Matheney Email: permits@washingtonenergy.com Address: 3909 196th St SW Phone #: 2063786648 Lynnwood WA 98036 Project Type Activity Type Scope of Work Single Family Residential Alteration Mechanical Project Name: 555 4th Ave S Description of Work: INSTALLING AC Project Details HVAC Systems Air Conditioner 1 Work Location Work Description/Location (example: 1st floor, EXTERIOR Master Bath, Garage) Page 2 of 2