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BLD2022-1256_Application_9.21.2022_6.22.41_AM_3120476CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1204947 - Black Residence Applicant First Name Last Name Company Name Greenwood Heating and AC Select Air Services DBA Greenwood Heating Number Street Apartment or Suite Number E-mail Address 14027 Interurban Ave S permits@greenwoodheating.com City State Zip Phone Number Extension Tukwila WA 98168 (206) 784-1818 Contractor Company Name GREENWOOD HEATING & A/C Number Street Apartment or Suite Number 14027 Interurban Ave S City State Zip Phone Number Extension Tukwila WA 98168 (206) 784-1818 State License Number License Expiration Date UBI # E-mail Address GREENHA9221.17 2/3/2023 F;n99sgn14 permits@greenwoodheating.com Project Location Number Street Floor Number Suite or Room Number 20210 81 ST AVE W City Zip Code County Parcel Number EDMONDS 98026 00431200002902 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 Reva Black Number Street Apartment or Suite Number 20210 81 ST 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: 9/21/2022 Submitted By: Greenwood Heating and AC Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1204947 - Black Residence Project Contact Company Name: Select Air Services DBA Greenwood Heating Name: Greenwood Heating and AC Email: permits@greenwoodheating.com Address: 14027 Interurban Ave S Phone #: (206) 784-1818 Tukwila WA 98168 Project Type Single Family Residential Activity Type Scope of Work Alteration Mechanical Project Name: Black Residence Description of Work: Install Air Handler and Heat Pump Project Details HVAC Systems Air Handler 10,000 CFM or less 1 Heat Pump 1 Work Location Work Description/Location (example: 1 st floor, closet and exterior Master Bath, Garage) Page 2 of 2