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Application_BLD2022-1400CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1215489 Applicant First Name Last Name Braxten Tacbian Company Name 1st Response Heating & Air Solutions LLC Number Street 1731 113th Dr SE Apartment or Suite Number E-mail Address info@lstresponsehvac.com City State Zip Lake Stevens WA 98258 Phone Number Extension (206) 643-1525 Contractor Company Name 1ST RESPONSE HTG/AIR SLTNS LLC Number Street 1731 113th Dr SE Apartment or Suite Number City State Zip Lake Stevens WA 98258 Phone Number Extension (206) 643-1525 State License Number License Expiration Date 1STRERH850P3 10/24/2023 UBI # E-mail Address F;ni_c,_r,7779 John@1stresponsehvac.com Project Location Number Street 21318 93RD PL W Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00781600000400 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 David R & Karen E Ttee Bhaskar Number Street 21318 93RD PL W Apartment or Suite Number City State EDMONDS WA Zip 98020-3300 Certification Statement - The applicant states: I certify that I am the owner of this property or the owner's authorized agent, including an appropriately licensed contractor. I have furnished true and correct information. I will comply with all provisions of law and ordinances governing this type of construction work, whether specific herein or not. By submitting this application I give the jurisdiction permission to enter the property to perform inspections. I understand that failure to comply with the above may result in revocation of the permit. Date Submitted: 10/13/2022 Submitted By: Braxten Tacbian Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1215489 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Mechanical Project Details HVAC Systems Furnace 1 Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1st floor, Garage Master Bath, Garage) Page 2 of 2