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Application_1283720CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1283720 Applicant First Name Last Name Kevin McBride Company Name Anderson Installation. Inc. Number Street 14616 Smokey Point Blvd Apartment or Suite Number E-mail Address andersonfireplace 1 @hotmail.com City State Zip Marysville WA 98271 Phone Number Extension (360) 651-7900 1 Contractor Company Name ANDERSON INSTALLATION INC Number Street 14616 Smokey Point Blvd Apartment or Suite Number City State Zip Marysville WA 98271 Phone Number Extension 360-651-7900 360-707-5225 State License Number License Expiration Date ANDER11961 LT 7/14/2024 UBI # E-mail Address FD9,iAF1 SD andersonfireplace 1 @hotmail.com Project Location Number Street 21913 80TH AVE W Floor Number Suite or Room Number City Zip Code EDMONDS 98026 County Parcel Number 00461000201101 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 Philip S Beyer Number Street 21913 80TH AVE W Apartment or Suite Number City State EDMONDS WA Zip 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: 3/15/2023 Submitted By: Kevin McBride Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1283720 Project Type Activity Type Scope of Work Single Family Residential Alteration Mechanical Project Details 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