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BLD2023-1185_Application_9.21.2023_10.20.05_AM_3796616CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1379358 - Roma 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 GREENHH7710M 9/14/2025ri(»griqn14 permits@greenwoodheating.com Project Location Number Street Floor Number Suite or Room Number 24111 104TH AVE W City Zip Code County Parcel Number EDMONDS 98020 00565000000800 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 Sharon Roma Number Street Apartment or Suite Number 24111 104TH AVE W City State Zip EDMONDS WA 98020-5720 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: 9/21/2023 Submitted By: Greenwood Heating and AC Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1379358 - Roma 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 Activity Type Single Family Residential Repair or Replacement Project Name: Roma Residence Description of Work: replace gas furnace. Install mini split system Project Details HVAC Systems Furnace 1 Heat Pump 1 Work Location Work Description/Location (example: 1 st floor, utility closet, exterior Master Bath, Garage) Scope of Work Mechanical Page 2 of 2