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Application_983078CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #983078 Applicant First Name Last Name Company Name Erin Gross Number Street Apartment or Suite Number E-mail Address 17303 72nd Ave W erin.danae.gross@gmail.com City State Zip Phone Number Extension Edmonds WA 98026 2069498222 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 17303 72ND AVE W City Zip Code County Parcel Number EDMONDS 98026 00513100013803 Associated Building Permit Number Tenant Name 956897 Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Mark F & Erin D Gross Number Street Apartment or Suite Number 17303 72ND 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, 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: 6/25/2021 Submitted By: Erin Gross Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #983078 Project Type Single Family Residential Project Details HVAC Systems Ventilation System Work Location Activity Type Scope of Work Alteration Mechanical Work Description/Location (example: 1 st floor, Whole house relocation of vent. Ducting in place and to Master Bath, Garage) remain Page 2 of 2