Application_1315181CITY OF EDMONDS MyBuildingPermit.com
Mechanical Application #1315181
Applicant
First Name Last Name Company Name
greg percy hearthside and home Ilc
Number Street Apartment or Suite Number E-mail Address
4829 196th st sw d hearthsideandhome@yahoo.com
City State Zip Phone Number Extension
lynnwood WA 98036 (425) 771-6434
Contractor
Company Name
hearthside and home Ilc
Number Street Apartment or Suite Number
4829 196th st sw d
City State Zip Phone Number Extension
lynnwood WA 98036 (425) 771-6434
State License Number License Expiration Date UBI # E-mail Address
HEARTHL868BC 1/3/2024 F ig15R1R hearthsideandhome@yahoo.com
Project Location
Number Street Floor Number Suite or Room Number
19928 MAPLEWOOD DR
City Zip Code County Parcel Number
EDMONDS 98026 00506700001701
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
Michael J & Annemarie T Thibodeau
Number Street Apartment or Suite Number
19928 MAPLEWOOD DR
City State Zip
EDMONDS WA 98026-6339
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: 5/12/2023 Submitted By: greg percy
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CITY OF EDMONDS MyBuildingPermit.com
Mechanical Application #1315181
Project Type Activity Type Scope of Work
Single Family Residential Alteration Mechanical
Project Details
Appliances and Equipment
Gas Piping Outlets - Mech 4
Associated Building Permit?
There is no other onsite work that requires a building
permit.
Other
Gas Fireplace 1
Work Location
Work Description/Location (example: 1 st floor, Main floor living room
Master Bath, Garage)
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