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Application_2021-1390CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1031814 Applicant First Name Last Name Drew Stancliffe Company Name Sutter Home and Hearth Inc Number Street 920 NW Leary Way Apartment or Suite Number E-mail Address install@sutterhearth.com City State Zip Seattle WA 98107 Phone Number Extension 2067839115 317 Contractor Company Name SUTTER HOME & HEARTH INC Number Street 920 NW Leary Way Apartment or Suite Number City State Zip Seattle WA 98107 Phone Number Extension (206) 783-9115 State License Number License Expiration Date SUTTEHH132JM 9/1/2023 UBI # E-mail Address FDmA47g1 install@sutterhearth.com Project Location Number Street 748 15TH WAY Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00389900000500 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 Trevor E & Mary Z Jazierski Number Street 748 15TH WAY SW 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: Drew Stancliffe Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1031814 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Mechanical Project Details Heaters Fireplace Insert - Gas 1 Work Location Work Description/Location (example: 1 st floor, 1st floor masonry fireplace. Master Bath, Garage) Page 2 of 2