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Application_2021-1171CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1010016 Applicant First Name Last Name Rich Vulliet Company Name Energy Works Number Street 7034 220th St SW Apartment or Suite Number E-mail Address info@energyworksnw.com City State Zip Mountlake Terrace WA 98043 Phone Number Extension (425) 409-5661 Contractor Company Name ENERGY WORKS LLC Number Street 7034 220th St SW Apartment or Suite Number City State Zip Mountlake Terrace WA 98043 Phone Number Extension (425) 409-5661 State License Number License Expiration Date ENERGWL88OKS 5/14/2022 UBI # E-mail Address F;nign4597 info@energyworksnw.com Project Location Number Street 9304 220TH ST SW Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00391900000100 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 Kaitlyn & Aaron Giboney Number Street 815 NW 54TH ST Apartment or Suite Number City State SEATTLE WA Zip 98107 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: 8/24/2021 Submitted By: Rich Vulliet Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1010016 Project Type Single Family Residential Project Details Other Tankless Gas Water Heater Work Location Activity Type Repair or Replacement Scope of Work Mechanical Work Description/Location (example: 1st floor, replacement in same location, ground level floor Master Bath, Garage) Page 2 of 2