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Application_1389725CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1389725 Applicant First Name Last Name Company Name Charity Teeters Advanced Installation Number Street Apartment or Suite Number E-mail Address PO BOX 1229 adv1 @advanced installation. net City State Zip Phone Number Extension Clinton WA 98236 (425) 745-5977 Contractor Company Name ADVANCED INSTALLATION INC Number Street Apartment or Suite Number PO BOX 1229 City State Zip Phone Number Extension Clinton WA 98236 (425) 745-5977 State License Number License Expiration Date UBI # E-mail Address ADVAN11033DU 3/13/2024 FD174gDq.,i adv1@advancedinstallation.net Project Location Number Street Floor Number Suite or Room Number 1105 8TH AVE S City Zip Code County Parcel Number EDMONDS 98020 00619401101000 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 Jack R Donaldson Number Street Apartment or Suite Number 1105 8TH AVE S 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, 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: 10/13/2023 Submitted By: Charity Teeters Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1389725 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Mechanical Project Details Heaters Fireplace Insert - Gas Work Location Work Description/Location (example: 1st floor, main floor Master Bath, Garage) Page 2 of 2