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Application_1068161CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1068161 Applicant First Name Last Name Valura Brashears Company Name Lifetime Heating & Air Conditioning Number Street 2801 Bickford Ave. Apartment or Suite Number E-mail Address Suite 103-148 valurab@lifetimeheating.com City State Zip Snohomish WA 98290 Phone Number Extension 4255534328 Contractor Company Name REFINED HEATING & A/C Number Street 5413 PANTHER LAKE RD Apartment or Suite Number City State Zip SNOHOMISH WA 98290 Phone Number Extension (425)359-5687 State License Number License Expiration Date LIFETHA8201_8 6/28/2022 UBI # E-mail Address RD4D54gBR valurab@lifetimeheating.com Project Location Number Street 18832 80TH AVE W Floor Number Suite or Room Number City Zip Code EDMONDS 98026 County Parcel Number 00481600100400 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 John Shelby & Renae Burford Number Street 4701 W 61ST TERRACE Apartment or Suite Number City State MISSION KS Zip 66205 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: 12/22/2021 Submitted By: Valura Brashears Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1068161 Project Type Activity Type Scope of Work Single Family Residential Alteration 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, basement Master Bath, Garage) Page 2 of 2