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BLD2021-0546+Application+4.15.2021_9.58.10_AM+2146994CITY OF EDMONDS MyBtaildingPermtt.com Mechanical Application #949908 - Distinctive Dentistry - Dr. Streit TI Applicant First Name Last Name Company Name Peter Crelley United Systems Mechanical, LLC Number Street Apartment or Suite Number E-mail Address 1400 Airport Way South 202 peter(D_us-mechanical.com City State Zip Phone Number Extension Seattle WA 98134 12065108080 Contractor Company Name UNITED SYSTEMS MECHANICAL LLC Number Street Apartment or Suite Number 1400 Airport Way South 202 City State Zip Phone Number Extension Seattle WA 98134 (206) 933-6036 State License Number License Expiration Date UBI # E-mail Address UNITESM962QA 11/1/2022 602439405 tyler(cD_us-mechanical.com Project Location Number Street Floor Number Suite or Room Number 22815 EDMONDS WAY 1st Floor None City Zip Code County Parcel Number EDMONDS 98020 27033600102700 Associated Building Permit Number Tenant Name Distinctive Dentistry - Dr. Streit Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name * DERKSEN LLC* Number Street Apartment or Suite Number 19827 15TH AVE NW City State Zip SHORELINE WA 98177 Certification Statement - The applicant states: I certify that I am the owner of this property or the owner's authorized agent. If acting as an authorized agent, I further certify that I have full power and authority to file this application and to perform, on behalf of the owner, all acts required to enable the jurisdiction to process and review such application. I have furnished true and correct information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of work requires a licensed contractor to perform the work, the information will be provided prior to permit issuance. Date Submitted: 4/15/2021 Submitted By: Peter Crelley Page 1 of 2 CITY OF EDMONDS Mysu;laingPerrntt.com Mechanical Application #949908 - Distinctive Dentistry - Dr. Streit TI Project Contact Company Name: LLCed Systems Mechanical, Name: Peter Crelley Email: peter@us-mechanical.com Address: 1400 Airport Way South 202 Phone #: 12065108080 Seattle WA 98134 Project Type Nonresidential Activity Type Alteration Project Name: Distinctive Dentistry - Dr. Streit TI Scope of Work Mechanical Three new interior general exhaust fans, three motorized Class I motorized back -draft Description of dampers and associated exhaust ductwork. Modify the existing diffusers and grilles per plan. Work: Two new (High/Low) Med Gas closet exterior wall penetrations. Relocate four existing indoor wall mounted duct -less units and associated refrigerant piping and condensate piping. Project Details Scope of Work Duct Work Only Mech Equipment Per Plans Work Location Work Description/Location (example: 1 st floor, All work on the 1 st floor. Master Bath, Garage) Page 2 of 2