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Application_1221173CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1221173 Applicant First Name CM Last Name Company Name Heating CM HEATING Number Street 1500 Industry St Apartment or Suite Number E-mail Address #200 HHAGEAGE@CMHEATING.COM City State EVERETT WA Zip Phone Number Extension 98203 (425) 259-0550 Contractor Company Name C M HEATING INC Number Street 1500 Industry ST Apartment or Suite Number Suite 200 City Everett State Zip Phone Number Extension WA 98203 (425) 259-6666 State License Number CMHEAI*095R4 License Expiration Date UBI # E-mail Address 5/4/2023 FD1 1 14F;5g HHAGEAGE@CMHEATING.COM Project Location Number Street 21607 81 ST AVE W Floor Number Suite or Room Number City EDMONDS Zip Code County Parcel Number 98026 00482300000800 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Jill E Last Name or Company Name Cartwright Number Street 21607 81 ST AVE W Apartment or Suite Number City EDMONDS State Zip WA 98026 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: 10/26/2022 Submitted By: CM Heating Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1221173 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Mechanical Project Details HVAC Systems Furnace Work Location Work Description/Location (example: 1st floor, interior Master Bath, Garage) Page 2 of 2