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Application_2021-1496CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1043320 Applicant First Name Last Name CM Heating Company Name CM HEATING Number Street Apartment or Suite Number 1415 Broadway E-mail Address HHAGEAGE@CMHEATING.COM City State Zip EVERETTT WA 98201 Phone Number Extension 4252590550 Contractor Company Name C M HEATING INC Number Street 1415 BROADWAY Apartment or Suite Number City State Zip EVERETTT WA 98201 Phone Number Extension 4252590550 State License Number License Expiration Date UBI # CMHEAI*095R4 5/4/2023 FD1 1 1465g E-mail Address HHAGEAGE@CMHEATING.COM Project Location Number Street 20209 84TH AVE W Floor Number Suite or Room Number City Zip Code County Parcel Number EDMONDS 98026 00431200000701 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 Julie A & Seeder Richard O Seeder Number Street 20209 84TH AVE. W. Apartment or Suite Number City State Zip EDMONDS WA 98026 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: 11/1/2021 Submitted By: CM Heating Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1043320 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Mechanical Project Details HVAC Systems Furnace 1 Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1st floor, GARAGE Master Bath, Garage) Page 2 of 2