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Application_2021-1172CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1010023 Applicant First Name CM Last Name Company Name Heating C.M. Heating, Inc Number Street 1415 Broadway Apartment or Suite Number E-mail Address kailana@cmheating.com City State Everett WA Zip Phone Number Extension 98201 4252596666 Contractor Company Name C M HEATING INC Number Street 1415 Broadway Apartment or Suite Number City Everett State Zip Phone Number Extension WA 98201 (425) 259-6666 State License Number CMHEAI*095R4 License Expiration Date UBI # E-mail Address 5/4/2023 F61 1 1465g kailana@cmheating.com Project Location Number Street 21004 82ND PL W Floor Number Suite or Room Number City EDMONDS Zip Code County Parcel Number 98026 00662200001800 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Benjamin Last Name or Company Name Palangeanu Number Street 21004 82ND PL W Apartment or Suite Number City EDMONDS State Zip 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: 8/24/2021 Submitted By: CM Heating Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1010023 Project Type Single Family Residential Project Details HVAC Systems Furnace Work Location Activity Type Repair or Replacement Work Description/Location (example: 1st floor, UTILITY ROOM Master Bath, Garage) Scope of Work Mechanical Page 2 of 2