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Application_1041768CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1041768 Applicant First Name Last Name David Vilensky Company Name Dvac Heating & Air LLC Number Street 10116 50th PI W Apartment or Suite Number E-mail Address dvacducts@gmail.com City State Zip Mukilteo WA 98275 Phone Number Extension 4259080030 Contractor Company Name DVAC HEATING & AIR LLC Number Street 4516 132ND PL SE APT 301 Apartment or Suite Number City State Zip MILL CREEK WA 98012 Phone Number Extension 2088169158 State License Number License Expiration Date DVACHHA821 NB 8/5/2022 UBI # E-mail Address Rums154 dvacducts@gmail.com Project Location Number Street 9135 184TH ST SW Floor Number Suite or Room Number City Zip Code EDMONDS 98026 County Parcel Number 00588200000600 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 Dale P Reisner Number Street 3585 BELLS BEACH RD Apartment or Suite Number City State LANGLEY WA Zip 98260 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: 11/2/2021 Submitted By: David Vilensky Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1041768 Project Type Single Family Residential Project Details Heaters Fireplace Insert - Gas Associated Building Permit? Activity Type Repair or Replacement There is no other onsite work that requires a building permit. Work Location Scope of Work Mechanical Work Description/Location (example: 1st floor, MAIN FLOOR LIVING AREA/CRAWL SPACE Master Bath, Garage) Page 2 of 2