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BLD2021-1637_Application_12.3.2021_3.07.30_PM_2552811CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1059094 - fischer mech permit Applicant First Name Last Name Company Name CM Heating CM HEATING Number Street Apartment or Suite Number E-mail Address 1415 Broadway HHAGEAGE@CMHEATING.COM City State Zip Phone Number Extension EVERETTT WA 98201 4252590550 Contractor Company Name C M HEATING INC Number Street Apartment or Suite Number 1415 Broadway City State Zip Phone Number Extension EVERETTT WA 98201 4252590550 State License Number License Expiration Date UBI # E-mail Address CMHEAI*095R4 5/4/2023 FD1 1 1465g HHAGEAGE@CMHEATING.COM Project Location Number Street Floor Number Suite or Room Number 23127 99TH AVE W City Zip Code County Parcel Number EDMONDS 98020 00391400002100 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 Gregory G & Lynda D Fischer Number Street Apartment or Suite Number 23127 99TH AVE W City State Zip EDMONDS WA 98020-5084 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: 12/3/2021 Submitted By: CM Heating Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1059094 - fischer mech permit Project Contact Company Name: CM HEATING Name: CM Heating Email: HHAGEAGE@CMHEATING.COM Address: 1415 Broadway Phone #: 4252590550 EVERETTT WA 98201 Project Type Activity Type Scope of Work Single Family Residential Alteration Mechanical Project Name: fischer mech permit Description of Work: gas furnace and heat pump install Project Details HVAC Systems Furnace 1 Heat Pump 1 Work Location Work Description/Location (example: 1st floor, interior/exterior Master Bath, Garage) Page 2 of 2