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Application_1467276CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1467276 Applicant First Name Last Name Brian Lee Company Name Sundance Energy Services Inc Number Street 10228 Main Street Apartment or Suite Number E-mail Address brianl@sundanceenergy.com City State Zip Bothell WA 98011 Phone Number Extension (425) 481-9660 Contractor Company Name Sundance Energy Services Inc Number Street 10228 Main Street Apartment or Suite Number City State Zip Bothell WA 98011 Phone Number Extension (425) 481-9660 State License Number License Expiration Date SUNDAES063J9 9/13/2025 UBI # E-mail Address BD15416:37 kevinl@sundanceenergy.com Project Location Number Street 17514 TALBOT RD Floor Number Suite or Room Number City Zip Code EDMONDS 98026 County Parcel Number 00594400002902 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 Tom L Summe Number Street 17514 TALBOT RD Apartment or Suite Number City State EDMONDS 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: 4/2/2024 Submitted By: Brian Lee Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1467276 Project Type Single Family Residential Project Details Heaters Fireplace Insert - Gas Associated Building Permit? Activity Type Repair or Replacement There is no other onsite work that requires a building permit. Work Location Scope of Work Mechanical Work Description/Location (example: 1st floor, Replacing existing gas fireplace insert in family room Master Bath, Garage) Page 2 of 2