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BLD2022-1131_Application_8.23.2022_7.33.28_AM_3065440CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1191458 - RGH Construction Applicant First Name Last Name Company Name Kathleen Kappen Ballard Natural Gas Service Number Street Apartment or Suite Number E-mail Address 2027 196th St SW A101 permits@ballardnaturalgas.com City State Zip Phone Number Extension Lynnwood WA 98036 (206) 784-8101 Contractor Company Name BALLARD NATURAL GAS SRVC INC Number Street Apartment or Suite Number 2027 196th St SW A101 City State Zip Phone Number Extension Lynnwood WA 98036 (206) 784-8101 State License Number License Expiration Date UBI # E-mail Address BALLANG062QD 12/6/2023 BD15nR.147 permits@ballardnaturalgas.com Project Location Number Street Floor Number Suite or Room Number 10608 231 ST ST SW City Zip Code County Parcel Number EDMONDS 98020 00476000000500 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 Leigh F Harvey Number Street Apartment or Suite Number 10608 231 ST ST SW City State Zip EDMONDS WA 98020-6153 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: 8/23/2022 Submitted By: Kathleen Kappen Page 1 of 2 CITY OF EDMONDS M BuildingPermit.com Mechanical Application #1191458 - RGH Construction Project Contact Company Name: Ballard Natural Gas Service Name: Kathleen Kappen Email: permits@ballardnaturalgas.com Address: 2027 196th St SW A101 Phone #: (206) 784-8101 Lynnwood WA 98036 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Mechanical Project Name: RGH Construction Description of Work: Installation of Mitsubishi heat pump Project Details HVAC Systems Heat Pump 1 Work Location Work Description/Location (example: 1 st floor, First floor. Master Bath, Garage) Page 2 of 2