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Application_1389769CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1389769 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� adv1@advancedinstallation.net Project Location Number Street Floor Number Suite or Room Number 7527 172ND ST SW City Zip Code County Parcel Number EDMONDS 98026 00513100012222 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 Kaveh Noorbakhsh Number Street Apartment or Suite Number 7527 172ND ST SOUTHWEST City State Zip EDMONDS WA 98026 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 #1389769 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Mechanical Project Details Heaters Fireplace Insert - Gas 2 Work Location Work Description/Location (example: 1 st floor, main floor & Master Bedroom Master Bath, Garage) Page 2 of 2