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Application BLD2023-0419CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1294375 Applicant First Name Last Name Company Name Christina Fritz Evergreen State Sheet Metal Number Street Apartment or Suite Number E-mail Address 8431 Maltby Rd christina@essmwa.com City State Zip Phone Number Extension Snohomish WA 98296 (425) 252-3114 Contractor Company Name EVERGREEN STATE SHEET MTL INC Number Street Apartment or Suite Number 8431 Maltby Rd City State Zip Phone Number Extension Snohomish WA 98296 (425) 252-3114 State License Number License Expiration Date UBI # E-mail Address EVERGSS0220T 10/10/2023 5D1794.157 christina@essmwa.com Project Location Number Street Floor Number Suite or Room Number 1611 9TH AVE N City Zip Code County Parcel Number EDMONDS 98020 27031300411300 Associated Building Permit Number Tenant Name 23-8007 Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Anthony G Starkovich Number Street Apartment or Suite Number 1611 9TH AVE N City State Zip EDMONDS WA 98020-2628 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: 4/5/2023 Submitted By: Christina Fritz Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1294375 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, Basement Master Bath, Garage) Page 2 of 2