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Application_1377004CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1377004 Applicant First Name greg Last Name percy Company Name hearthside and home Ilc Number Street 4829 196th st sw Apartment or Suite Number E-mail Address d hearthsideandhome@yahoo.com City State lynnwood WA Zip 98036 Phone Number Extension (425) 771-6434 Contractor Company Name hearthside and home Ilc Number Street 4829 196th st sw Apartment or Suite Number d City lynnwood State Zip WA 98036 Phone Number Extension (425) 771-6434 State License Number HEARTHL868BC License Expiration Date 1/3/2024 UBI # E-mail Address F ig15R1R hearthsideandhome@yahoo.com Project Location Number Street 1034 4TH AVE S Floor Number Suite or Room Number City EDMONDS Zip Code 98020 County Parcel Number 00695800000600 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Suzanne Last Name or Company Name James Number Street 1034 4TH AVE S Apartment or Suite Number City EDMONDS State WA Zip 98020 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: 9/15/2023 Submitted By: greg percy Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1377004 Project Type Single Family Residential Project Details Appliances and Equipment Gas Piping Outlets - Mech Heaters Fireplace Insert - Gas Associated Building Permit? Activity Type Scope of Work Alteration Mechanical There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1 st floor, Main floor, living room, masonry fireplace. Master Bath, Garage) Page 2 of 2