Application_1413415CITY OF EDMONDS MyBuildingPermit.com
Mechanical Application #141341
Applicant
First Name Last Name Company Name
jason burge Black Lion Heating and Air Conditioning
Number Street Apartment or Suite Number E-mail Address
11001 118th pl ne info@blacklionhvac.com
City State Zip Phone Number Extension
KIRKLAND WA 98033 (425) 814-3944
Contractor
Company Name
BLACK LION HEATING & A/C LLC
Number Street Apartment or Suite Number
11001 118th PL NE
City State Zip Phone Number Extension
KIRKLAND WA 98033 (425) 814-3944
State License Number License Expiration Date UBI # E-mail Address
BLACKLH873QQ 11/18/2025 Rnimsggn info@blacklionhvac.com
Project Location
Number Street Floor Number Suite or Room Number
303 WALNUT ST
City Zip Code County Parcel Number
EDMONDS 98020 01136800020100
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
MASTERPIECE PROPERTIES LLC
Number Street Apartment or Suite Number
6111 W TREE DR
City State Zip
ANCHORAGE AK 99507
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: 12/6/2023 Submitted By: jason burge
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CITY OF EDMONDS MyBuildingPermit.com
Mechanical Application #1413415
Project Type Activity Type Scope of Work
Single Family Residential Repair or Replacement Mechanical
Project Details
Appliances and Equipment
Gas Piping Outlets - Mech
Work Location
Work Description/Location (example: 1st floor,
Master Bath, Garage) garage
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