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BLD2022-1627_Application_11.28.2022_10.03.41_AM_3212483CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1227720 - Anderson Tod & Sue Applicant First Name Last Name Company Name Kevin McBride Anderson Installation. Inc. Number Street Apartment or Suite Number E-mail Address 14616 Smokey Point Blvd andersonfireplace 1 @hotmail.com City State Zip Phone Number Extension Marysville WA 98271 (360) 651-7900 1 Contractor Company Name ANDERSON INSTALLATION INC Number Street Apartment or Suite Number 14616 Smokey Point Blvd City State Zip Phone Number Extension Marysville WA 98271 360-651-7900 360-707-5225 State License Number License Expiration Date UBI # E-mail Address ANDER11961 LT 7/14/2024 FD9,iAF1 SD andersonfireplace 1 @hotmail.com Project Location Number Street Floor Number Suite or Room Number 524 MAPLE ST 201 City Zip Code County Parcel Number EDMONDS 98020 00728900220100 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 Tod J & Susan L Anderson Number Street Apartment or Suite Number 524 MAPLE ST 201 City State Zip EDMONDS WA 98020 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: 11/28/2022 Submitted By: Kevin McBride Page 1 of 2 CITY OF EDMONDS M BuitdingPermit.com Mechanical Application #1227720 - Anderson Tod & Sue Project Contact Company Name: Anderson Installation. Inc. Name: Kevin McBride Email: andersonfireplace1@hotmail.com Address: 14616 Smokey Point Phone #: (360) 651-7900 1 Blvd Marysville WA 98271 Project Type Single Family Condominium Unit Activity Type Scope of Work Alteration Mechanical Project Name: Anderson Tod & Sue Description of Work: Install gas pipe with direct vent gas insert Project Details Scope of Work Mech Equipment For Building Permit Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1st floor, Living room Master Bath, Garage) Page 2 of 2