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Application_2021-0828CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #978496 Applicant First Name Last Name Tim Detschman Company Name Complete Mechanical Number Street 2020 Oak rd Apartment or Suite Number E-mail Address Tim@complete-hvac.com City State Zip Lynnwood WA 98087 Phone Number Extension 4257426897 Contractor Company Name COMPLETE MECHANICAL INC Number Street 2020 Oak Road Apartment or Suite Number City State Zip Lynnwood WA 98087 Phone Number Extension (206) 947-1463 State License Number License Expiration Date complmi055pt 1/8/2023 UBI # E-mail Address Rn1 RR4g7D Tim@complete-hvac.com Project Location Number Street 22109 95TH PL W Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00544200200500 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 Tom H Haley Number Street 22109 95TH PL W Apartment or Suite Number City State EDMONDS WA Zip 98020-4519 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: 6/16/2021 Submitted By: Tim Detschman Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #978496 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Mechanical Project Details HVAC Systems Furnace 1 Work Location Work Description/Location (example: 1st floor, garage, remove and replace furnace Master Bath, Garage) Page 2 of 2