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Application_2021-1388CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1031809 Applicant First Name Last Name Greenwood Heating and AC Company Name Select Air Services DBA Greenwood Heating Number Street 825 S Stacy ST Apartment or Suite Number E-mail Address permits@greenwoodheating.com City State Zip Seattle WA 98134 Phone Number Extension 2067841818 Contractor Company Name GREENWOOD HEATING & A/C Number Street 825 S STACY ST Apartment or Suite Number City State Zip Seattle WA 98134 Phone Number Extension (206) 784-1818 State License Number License Expiration Date GREENHA9221J7 2/3/2023 UBI # E-mail Address F;n99sgn14 permits@greenwoodheating.com Project Location Number Street 19420 88TH AVE W Floor Number Suite or Room Number City Zip Code EDMONDS 98026 County Parcel Number 27041800312200 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 John R & Carol G Potter Number Street 19420 88TH AVE W 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: 10/8/2021 Submitted By: Greenwood Heating and AC Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1031809 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Mechanical Project Details HVAC Systems Furnace Work Location Work Description/Location (example: 1st floor, Garage Master Bath, Garage) Page 2 of 2