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BLD2022-1689+Application+12.13.2022_9.02.30_AM+3265693CITY OF EDMONDS nnyst,ilaingPermit.com Mechanical Application #1238869 - Copperpot Bakery Applicant First Name Last Name Company Name Tim Green Pacific Mechanical Systems Inc Number Street Apartment or Suite Number E-mail Address 2100 196th Street SW 123 accounting(�D_pacmech-hvac.com City State Zip Phone Number Extension Lynnwood WA 98036 (206) 771-0222 Contractor Company Name PACIFIC MECHANICAL SYSTEMS INC Number Street Apartment or Suite Number 2100 196TH ST SW #123 City State Zip Phone Number Extension LYNNWOOD WA 98036 (425)771-2495 2067710222 State License Number License Expiration Date UBI # E-mail Address PACIFMS034137 2/10/2024 601764457 accounting(a)_pacmech-hvac.com Project Location Number Street Floor Number Suite or Room Number 550 MAIN ST 1 none City Zip Code County Parcel Number EDMONDS 98020 00434212001500 Associated Building Permit Number Tenant Name BLD2021-0797 Copperpot Bakery Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name SEATTLE-SNOHOMISH MILL COMPANY INC Number Street Apartment or Suite Number 533 5th 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. 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: 12/13/2022 Submitted By: Tim Green Page 1 of 2 CITY OF EDMONDS Mysu;laingPerrnit.com Mechanical Application #1238869 - Copperpot Bakery Project Contact Company Name: Pacific Mechanical Systems Inc Name: Tim Green Email: tim.green@pacmech-hvac.com Address: 2100 196th Street SW 123 Phone #: (206) 771-0222 Lynnwood WA 98036 Project Type Activity Type Scope of Work Nonresidential New Mechanical Project Name: Copperpot Bakery Description of Work: Installation of Type II commercial kitchen hood & duct work. Project Details Scope of Work Installation of equipment Associated Building Permit? There is or will be a building permit associated with this work at the project location. Work Location Work Description/Location (example: 1 st floor, First floor, kitchen. Copperpot Bakery. Master Bath, Garage) Page 2 of 2