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BLD2023-0708_Application_6.7.2023_3.06.06_PM_3594188CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1329210 - sorrels mech Applicant First Name Last Name Company Name jason burge Black Lion Heating and Air Conditioning Number Street Apartment or Suite Number E-mail Address 11001 118th pl ne info@blacklionhvac.com City State Zip Phone Number Extension KIRKLAND WA 98033 (425) 814-3944 Contractor Company Name BLACK LION HEATING & A/C LLC Number Street Apartment or Suite Number 11001 118th PL NE City State Zip Phone Number Extension KIRKLAND WA 98033 (425)814-3944 State License Number License Expiration Date UBI # E-mail Address BLACKLH873QQ 11/18/2023 Rnimsggn info@blacklionhvac.com Project Location Number Street Floor Number Suite or Room Number 590 HEMLOCK WAY City Zip Code County Parcel Number EDMONDS 98020 27032500209800 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 Mary A & James Heller Number Street Apartment or Suite Number 590 HEMLOCK WAY City State Zip EDMONDS WA 98026 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: 6/7/2023 Submitted By: jason burge Page 1 of 2 i CITY OF EDMONDS MyBuitdingPermit.com Mechanical Application #1329210 - sorrels mech Project Contact Company Name: Black Lion Heating and Air Conditioning Name: jason burge Email: info@blacklionhvac.com Address: 11001 118th pl ne Phone #: (425) 814-3944 KIRKLAND WA 98033 Project Type Activity Type Single Family Residential Repair or Replacement Project Name: sorrels mech Description of Work: furnace swap - hp add Project Details HVAC Systems Furnace 1 Heat Pump 1 Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1 st floor, furnace and hp Master Bath, Garage) Scope of Work Mechanical Page 2 of 2