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Application_1022005CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1022005 Applicant First Name COREY Last Name ALEXANDER Company Name Infrasource Services Number Street 1660 Park Lane Apartment or Suite Number E-mail Address corey.alexander@pse.com City State Burlington WA Zip 98233 Phone Number Extension 4255164388 Contractor Company Name Infrasource Services LLC Number Street 1660 Park Lane Apartment or Suite Number City Burlington State Zip WA 98233 Phone Number Extension (425) 466-4771 State License Number INFRASL871C2 License Expiration Date 2/22/2023 UBI # E-mail Address FD:199gssR corey.alexander@pse.com Project Location Number Street 1241 VISTA WAY Floor Number Suite or Room Number City EDMONDS Zip Code 98020 County Parcel Number 00507000001600 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Edward G & Theresa A Last Name or Company Name Brock Number Street 1241 VISTA WAY Apartment or Suite Number City EDMONDS State WA Zip 98020-2989 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: 9/20/2021 Submitted By: COREY ALEXANDER Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1022005 Project Type Activity Type Scope of Work Single Family Residential Alteration Mechanical Project Details Appliances and Equipment Gas Piping Outlets - Mech Work Location Work Description/Location (example: 1 st floor, 1 st Master Bath, Garage) Page 2 of 2