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BLD2022-1655_Application_12.6.2022_11.27.07_AM_3254392CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1238793 - Hoelzle, M - installing ductless HVAC system Applicant First Name Last Name Company Name Rich Vulliet Energy Works Number Street Apartment or Suite Number E-mail Address 7034 220th St SW info@energyworksnw.com City State Zip Phone Number Extension Mountlake Terrace WA 98043 (425) 409-5661 Contractor Company Name ENERGY WORKS LLC Number Street Apartment or Suite Number 7034 220th St SW City State Zip Phone Number Extension Mountlake Terrace WA 98043 (425) 409-5661 State License Number License Expiration Date UBI # E-mail Address ENERGWL88OKS 5/14/2024 F;nign4597 info@energyworksnw.com Project Location Number Street Floor Number Suite or Room Number 22718 96TH AVE W City Zip Code County Parcel Number EDMONDS 98020 00450700900004 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 Melanie Hoelzle Number Street Apartment or Suite Number 22718 96TH AVE W City State Zip EDMONDS WA 98020-4533 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: 12/6/2022 Submitted By: Rich Vulliet Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1238793 - Hoelzle, M - installing ductless HVAC system Project Contact Company Name: Energy Works Name: Rich Vulliet Email: info@energyworksnw.com Address: 7034 220th St SW Phone #: (425) 409-5661 Mountlake Terrace WA 98043 Project Type Single Family Residential Activity Type Scope of Work Alteration Mechanical Project Name: Hoelzle, M - installing ductless HVAC system Description of Work: Installing 5 zone Ductless system with 1 heat pump on north outside wall of the house, Project Details HVAC Systems Heat Pump Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) 1 outdoor -ground level -north side of the house, indoor- all bedrooms. Page 2 of 2