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BLD2021-1645_Application_12.6.2021_11.27.21_AM_2554962CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1059732 - Waite Boiler Install Applicant First Name Last Name Company Name NW Mechanical NW Mechanical Number Street Apartment or Suite Number E-mail Address 3204 NE 145th Street rachel@nwmechanical.com City State Zip Phone Number Extension Shoreline WA 98155 (206)486-3559 Contractor Company Name Northwest Mechanical Number Street Apartment or Suite Number 3204 NE 145th St. City State Zip Phone Number Extension SHORELINE WA 98155 2062674328 State License Number License Expiration Date UBI # E-mail Address NORTHM*799CA 2/9/2023 RuR899D.,i rachel@nwmechanical.com Project Location Number Street Floor Number Suite or Room Number 111 ELM ST City Zip Code County Parcel Number EDMONDS 98020 00582000401001 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 Stephen C & Yamane Joyce K Ttee Waite Number Street Apartment or Suite Number 111 ELM ST City State Zip EDMONDS WA 98020-4105 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: 12/6/2021 Submitted By: NW Mechanical Page 1 of 2 CITY OF EDMONDS M BuildingPermit.com Mechanical Application #1059732 - Waite Boiler Install Project Contact Company Name: NW Mechanical Name: NW Mechanical Email: daniel@nwmechanical.com Address: 3204 NE 145th Street Phone #: (206)486-3560 Shoreline WA 98155 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Mechanical Project Name: Waite Boiler Install Description of Work: Demo old boiler and install new Bosch Greenstar Floor Mounted KBR42-3 151,000 BTU boiler Project Details Boilers and Water Heaters Boiler or Compressor 100,001 to 499,000 BTU 1 Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1 st floor, Replace old boiler in Mechanical room Master Bath, Garage) Page 2 of 2