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BLD2021-1201+Application+8.30.2021_10.40.54_AM+2382733CITY OF EDMONDS M BtaildingPermit.com Mechanical Application #1012530 - MTI PHYCIAL THERATPY TENANT IMPROVEMEI Applicant First Name Last Name Company Name John Merrill MECHANICAL & CONTROL SERVICES Number Street Apartment or Suite Number E-mail Address 6426 18TH ST E johnm(�D_groupmcs.com City State Zip Phone Number Extension FIFE WA 98424 2538314446 Contractor Company Name MECHANICAL & CONTROL SRVCS INC Number Street Apartment or Suite Number 6426 18th Street East City State Zip Phone Number Extension Fife WA 98424 (253) 926-9777 State License Number License Expiration Date UBI # E-mail Address MECHACS962BT 2/26/2022 602338440 lohnm(c-)groupmcs.com Project Location Number Street Floor Number Suite or Room Number 21616 76TH AVE W 1 102 City Zip Code County Parcel Number EDMONDS 98026 00461000100101 Associated Building Permit Number Tenant Name MTI PHYSICAL THERAPY Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name HR ACQUISITION I CORPORATION Number Street Apartment or Suite Number 3310 ND AVE STE 700 City State Zip NASHVILLE TN 37203 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: 8/30/2021 Submitted By: John Merrill Page 1 of 2 CITY OF EDMONDS MYBuildingPerrnit.com Mechanical Application #1012530 - MTI PHYCIAL THERATPY TENANT IMPROVEMEI Project Contact Company Name: MECHANICAL & CONTROL SERVICES Name: John Merrill Email: johnm@groupmcs.com Address: 6426 18TH ST E Phone #: 2538314446 FIFE WA 98424 Project Type Nonresidential Activity Type Alteration Scope of Work Mechanical Project Name: MTI PHYCIAL THERATPY TENANT IMPROVEMENT Description of Work: MODIFY EXISTING DUCT SYSTEM TO ACCOMMODATE NEW FLOOR LAYOUT. Project Details Scope of Work Duct Work Only Work Location Work Description/Location (example: 1st floor, RELOACTE EXISTING DIFFUSERS AND GRILLES Master Bath, Garage) TO ACCOMMOADTE NEW FLOOR LAYOUT. Page 2 of 2