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Application_1407168CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1407168 Applicant First Name Last Name Greenwood Heating and AC Company Name Select Air Services DBA Greenwood Heating Number Street 14027 Interurban Ave S Apartment or Suite Number E-mail Address permits@greenwoodheating.com City State Zip Tukwila WA 98168 Phone Number Extension (206) 784-1818 Contractor Company Name GREENWOOD HEATING & HOME SRVS Number Street 14027 Interurban Ave S Apartment or Suite Number City State Zip Tukwila WA 98168 Phone Number Extension (206) 784-1818 State License Number License Expiration Date GREENHH7710M 9/14/2025ri(»griqn14 UBI # E-mail Address permits@greenwoodheating.com Project Location Number Street 614 12TH AVE N Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00427000000600 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 Karen Dejong Number Street 614 12TH AVE N Apartment or Suite Number City State EDMONDS 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: 11/20/2023 Submitted By: Greenwood Heating and AC Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1407168 Project Type Single Family Residential Project Details HVAC Systems Furnace Work Location Activity Type Repair or Replacement Work Description/Location (example: 1st floor, outside closet Master Bath, Garage) Scope of Work Mechanical Page 2 of 2