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BLD2022-0512_Application_4.26.2022_7.28.29_AM_2826607CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1131392 - Mohagen Applicant First Name Last Name Company Name NW Mechanical NW Mechanical Number Street Apartment or Suite Number E-mail Address 3204 NE 145th Street Permit@nwmechanical.com City State Zip Phone Number Extension Shoreline WA 98155 2064863559 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 Permit@nwmechanical.com Project Location Number Street Floor Number Suite or Room Number 8608 194TH PL SW City Zip Code County Parcel Number EDMONDS 98026 00506100000600 Associated Building Permit Number Tenant Name Mohagen Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Marc G & Mary A Mohagen Number Street Apartment or Suite Number 8608 194TH PL SW City State Zip EDMONDS WA 98026 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: 4/26/2022 Submitted By: NW Mechanical Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1131392 - Mohagen Project Contact Company Name: Name: Address: Mary Mohagen 8608 194th PI SW Edmonds WA 98026 Email: mmohagen@comcast.net Phone #: 4256720708 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Mechanical Project Name: Mohagen Description of Work: boiler swap BUDERUS GC144/411 SLENDER MODEL 103,0000 BTU gas Project Details Boilers and Water Heaters Boiler or Compressor 100,001 to 499,000 BTU Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) 1 Boiler swap BUDERUS GC144/411 SLENDER MODEL 103,0000 BTU Page 2 of 2