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Application_1014707CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1014707 Applicant First Name Last Name Kevin McBride Company Name Anderson Installation. Inc. Number Street 14616 Smokey Point Blvd Apartment or Suite Number E-mail Address andersonfireplace 1 @hotmail.com City State Zip Marysville WA 98271 Phone Number Extension 3606517900 1 Contractor Company Name ANDERSON INSTALLATION INC Number Street 14616 Smokey Point Blvd Apartment or Suite Number City State Zip Marysville WA 98271 Phone Number Extension 360-651-7900 360-707-5225 State License Number License Expiration Date ANDER11961 LT 7/14/2022 UBI # E-mail Address FD9,iAF1 SD andersonfireplace 1 @hotmail.com Project Location Number Street 960 CEDAR ST Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 27032500101200 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 Gerald L Lloyd Number Street 960 CEDAR ST Apartment or Suite Number City State EDMONDS WA Zip 98020 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: 9/2/2021 Submitted By: Kevin McBride Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1014707 Project Type Single Family Residential Project Details Appliances and Equipment Gas Piping Outlets - Mech Heaters Fireplace Insert - Gas Work Location Activity Type Scope of Work Alteration Mechanical Work Description/Location (example: 1st floor, Living room Master Bath, Garage) Page 2 of 2