BLD2021-0667+Application+5.12.2021_1.51.23_PM+2193351CITY OF EDMONDS
Mechanical Application #962230 - Lakeshore
Applicant
First Name Last Name
D Jason Nordstrom
Number Street Apartment or Suite Number
1059 State Ave G
City State
Zip
Marysville WA
98270
Contractor
Company Name
NORDSTROM HEATING & AIR
INC
Number Street
4717 87th Ave NE
City
State Zip
Marysville
WA 98270
State License Number
License Expiration Date UBI #
NORDSHA884JW
4/16/2022 602279145
Project Location
Number Street
660 EDMONDS WAY
MyBuildingPermit.com
Company Name
Nordstrom Heatinq & Air, Inc
E-mail Address
officel_c�i_nordstromheatinq.com
Phone Number Extension
3603869819
Apartment or Suite Number
Phone Number Extension
(360-386-9819
E-mail Address
office(cD_nordstromheatinq.com
City Zip Code County Parcel Number
EDMONDS 98020 27032500309200
Associated Building Permit Number Tenant Name
Maid Pro
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
Floor Number Suite or Room Number
1 #B
First Name Last Name or Company Name
Al Gosiak LAKESHORE INVESTMENT CORP
Number Street Apartment or Suite Number
2633 EASTLAKE AVE E 307
City State Zip
SEATTLE WA 98102
Certification Statement - The applicant states:
I certify that I am the owner of this property or the owner's authorized agent. If acting as an authorized agent, I further certify that I have full power and
authority to file this application and to perform, on behalf of the owner, all acts required to enable the jurisdiction to process and review such application. I
have furnished true and correct information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of work
requires a licensed contractor to perform the work, the information will be provided prior to permit issuance.
Date Submitted: 5/12/2021 Submitted By: D Jason Nordstrom
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CITY OF EDMONDS MyBoi[di ngPerrnit.com
Mechanical Application #962230 - Lakeshore
Project Contact
Company Name: Nordstrom Heating & Air,
Inc
Name: Jason Nordstrom Email: jason@nordstromheating.com
Address: 1059 State Ave g Phone #: 360-386-9819
Marysville wa 98270
Project Type Activity Type Scope of Work
Nonresidential Repair or Replacement Mechanical
Project Name: Lakeshore
Description of Work: Like for like 2-Ton (24K Btu) roof top packaged heat pump replacement
Project Details
Scope of Work
Like for like equipment in the same location
Work Location
Work Description/Location (example: 1 st floor, Roof Top
Master Bath, Garage)
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