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BLD2023-0918_Application_7.24.2023_7.46.48_AM_3683427CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1352090 - Khalaf Residence Applicant First Name Last Name Company Name Greenwood Heating and AC Select Air Services DBA Greenwood Heating Number Street Apartment or Suite Number E-mail Address 14027 Interurban Ave S permits@greenwoodheating.com City State Zip Phone Number Extension Tukwila WA 98168 (206) 784-1818 Contractor Company Name GREENWOOD HEATING & A/C Number Street Apartment or Suite Number 14027 Interurban Ave S City State Zip Phone Number Extension Tukwila WA 98168 (206) 784-1818 State License Number License Expiration Date UBI # E-mail Address GREENHA9221.17 2/3/2025 F;n99sgn14 permits@greenwoodheating.com Project Location Number Street Floor Number Suite or Room Number 9421 217TH ST SW City Zip Code County Parcel Number EDMONDS 98020 00527900000300 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 Osama Khalaf Number Street Apartment or Suite Number 9421 217TH ST SW City State Zip EDMONDS WA 98020 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: 7/24/2023 Submitted By: Greenwood Heating and AC Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1352090 - Khalaf Residence Project Contact Company Name: Select Air Services DBA Greenwood Heating Name: Greenwood Heating and AC Email: permits@greenwoodheating.com Address: 14027 Interurban Ave S Phone #: (206) 784-1818 Tukwila WA 98168 Project Type Single Family Residential Activity Type Scope of Work Alteration Mechanical Project Name: Khalaf Residence Description of Work: install AC to existing furnace Project Details HVAC Systems Air Conditioner Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) 1 exterior back yard Page 2 of 2