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BLD2022-0570_Application_5.4.2022_3.39.35_PM_2847826CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1137176 - SALLY JOHNSON MECH Applicant First Name Last Name Company Name CM Heating CM HEATING Number Street Apartment or Suite Number E-mail Address 1415 Broadway BMILLER@CMHEATING.COM City State Zip Phone Number Extension EVERETT WA 98201 4252590550 Contractor Company Name C M HEATING INC Number Street Apartment or Suite Number 1415 Broadway City State Zip Phone Number Extension Everett WA 98201 (425) 259-6666 State License Number License Expiration Date UBI # E-mail Address CMHEAI*095R4 5/4/2023 BD111465g BMILLER@CMHEATING.COM Project Location Number Street Floor Number Suite or Room Number 19007 84TH AVE W City Zip Code County Parcel Number EDMONDS 98026 00481600401400 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 Sally L Johnson Number Street Apartment or Suite Number 19007 84TH AVE W 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: 5/4/2022 Submitted By: CM Heating Page 1 of 2 CITY OF EDMONDS M BuildingPermit.com Mechanical Application #1137176 - SALLY JOHNSON MECH Project Contact Company Name: CM HEATING Name: CM Heating Address: 1415 Broadway EVERETT WA 98201 Project Type Single Family Residential Email: BMILLER@CMHEATING.COM Phone #: 4252590550 Activity Type Repair or Replacement Project Name: SALLY JOHNSON MECH Description of Work: INSTALL DUCTLESS HP Project Details HVAC Systems Heat Pump 1 Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1st floor, outside Master Bath, Garage) Scope of Work Mechanical Page 2 of 2