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BLD2023-1155_Application_9.13.2023_3.39.20_PM_3781621CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1375683 - Kurlinski Applicant First Name Last Name Company Name Katrina Simonson Green City Heating and Air Conditioning Number Street Apartment or Suite Number E-mail Address 19107 SE 314th PI greencityhvac@gmail.com City State Zip Phone Number Extension Kent WA 98042 (206) 227-6616 Contractor Company Name Green City HTG & A/C INC Number Street Apartment or Suite Number 311 3rd St NE City State Zip Phone Number Extension Auburn WA 98002 (206) 227-6616 State License Number License Expiration Date UBI # E-mail Address GREENCH866132 1/22/2024 F;m'lR.17.1q greencityhvac@gmail.com Project Location Number Street Floor Number Suite or Room Number 9855 225TH PL SW City Zip Code County Parcel Number EDMONDS 98020 00450700600005 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 Virginia J Kurlinski Number Street Apartment or Suite Number 9855 225TH PL 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: 9/13/2023 Submitted By: Katrina Simonson Page 1 of 2 CITY OF EDMONDS M BuildingPermit.com Mechanical Application #1375683 - Kurlinski Project Contact Company Name: Green City Heating and Air Conditioning Name: Katrina Simonson Email: greencityhvac@gmail.com Address: 19107 SE 314th PI Phone #: (206) 227-6616 Kent WA 98042 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Mechanical Project Name: Kurlinski Description of Work: replacing boiler Project Details Boilers and Water Heaters Boiler or Compressor 100,000 BTU or less 1 Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) garage Page 2 of 2