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Application_1432656CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1432656 Applicant First Name greg Last Name percy Company Name hearthside and home Ilc Number Street 4829 196th st sw Apartment or Suite Number E-mail Address d hearthsideandhome@yahoo.com City State lynnwood WA Zip 98036 Phone Number Extension (425) 771-6434 Contractor Company Name hearthside and home llc Number Street 4829 196th st sw Apartment or Suite Number d City lynnwood State Zip WA 98036 Phone Number Extension (425) 771-6434 State License Number H EARTHL868BC License Expiration Date 1 /3/2026 UBI # E-mail Address F;miq 15R 1 R hearthsideandhome@yahoo.com Project Location Number Street 18813 81 ST AVE W Floor Number Suite or Room Number City EDMONDS Zip Code 98026 County Parcel Number 00481600101300 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Douglas A Last Name or Company Name Pierce Number Street 18813 81 ST AVE W Apartment or Suite Number City EDMONDS State WA Zip 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: 1/23/2024 Submitted By: greg percy Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1432656 Project Type Activity Type Scope of Work Single Family Residential Alteration Mechanical Project Details Heaters Fireplace Insert - Gas Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1 st floor, Remove existing gas insert and install new gas insert Master Bath, Garage) into masonry fireplace on main floor in family room. Page 2 of 2