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Application_1126827CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1126827 Applicant First Name Last Name Company Name Rafael Varela Number Street Apartment or Suite Number E-mail Address 22701 74th PL W rafavaru@gmail.com City State Zip Phone Number Extension Edmonds WA 98026 4254662876 Contractor Company Name Owner Number Street Apartment or Suite Number City State Zip Phone Number Extension State License Number License Expiration Date UBI # E-mail Address Project Location Number Street Floor Number Suite or Room Number 22701 74TH PL W City Zip Code County Parcel Number EDMONDS 98026 00535100200300 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 Rafael Varela Number Street Apartment or Suite Number 22701 74TH PL W City State Zip EDMONDS WA 98026-8383 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: 4/19/2022 Submitted By: Rafael Varela Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1126827 Project Type Activity Type Scope of Work Single Family Residential New Mechanical Project Details Appliances and Equipment Gas Piping Outlets - Mech 1 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, Main Master Bath, Garage) Page 2 of 2