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BLD2021-1693+Application+12.14.2021_4.43.54_PM+2573000CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1064598 - Seattle Skin and Laser Applicant First Name Last Name Company Name Lisa Cassaday Vital Mechanical Service Number Street Apartment or Suite Number E-mail Address 1420 Maple Ave SW Iisa.cassaday(cD_vitaImechanical. corn City State Zip Phone Number Extension Renton WA 98057 2066294828 Contractor Company Name VITAL MECHANICAL INC Number Street Apartment or Suite Number 1420 MAPLE AVE SW City State Zip Phone Number Extension RENTON WA 98057 (206)649-4828 (206)795-7855 State License Number License Expiration Date UBI # E-mail Address VITALM1792CP 2/26/2023 604659790 lisa.cassaday(a)_vitalmechanical.com Project Location Number Street Floor Number Suite or Room Number 21727 76TH AVE W 2nd Suite F City EDMONDS Associated Building Permit Number Zip Code County Parcel Number 98026 00580700002701 Tenant Name Seattle Skin and Laser Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Number Street PO BOX 92129 Last Name or Company Name HR ACQUISITION I CORPORATION Apartment or Suite Number City State Zip SOUTH LAKE TX 76092 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: 12/14/2021 Submitted By: Lisa Cassaday Page 1 of 2 CITY OF EDMONDS Mysu;laingPerrnit.com Mechanical Application #1064598 - Seattle Skin and Laser Project Contact Company Name: Vital Mechanical Service Name: Lisa Cassaday Email: lisa.cassaday@vitalmechanical.com Address: 1420 Maple Ave SW Phone #: 2066294828 Renton WA 98057 Project Type Activity Type Scope of Work Nonresidential Alteration Mechanical Project Name: Seattle Skin and Laser Description of Work: Seattle Skin and Laser - Install (1) new supply grille, relocate (2) existing supply grilles and (1) Return Grille and (1) thermostat. Project Details Scope of Work Mech Equipment Per Plans Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1 st floor, 2nd Floor Suite F Master Bath, Garage) Page 2 of 2