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BLD2024-0557_Application_4.26.2024_3.54.18_PM_4202406CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1474963 - Lazarus, Gary Applicant First Name Last Name Company Name Amy Revelle Ballard Natural Gas Service Number Street Apartment or Suite Number E-mail Address 2027 196th St SW A101 permits@ballardnaturalgas.com City State Zip Phone Number Extension Lynnwood WA 98036 (206) 784-8101 Contractor Company Name BALLARD NATURAL GAS SRVC INC Number Street Apartment or Suite Number 2027 196th St SW A101 City State Zip Phone Number Extension Lynnwood WA 98036 (206) 784-8101 State License Number License Expiration Date UBI # E-mail Address BALLANG062QD 12/6/2025 BD15nR.147 permits@ballardnaturalgas.com Project Location Number Street Floor Number Suite or Room Number 6909 174TH ST SW City Zip Code County Parcel Number EDMONDS 98026 00513100014523 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 Gary M & Nancy A Ttees Edwards -Lazarus Number Street Apartment or Suite Number 6909 174TH ST SW City State Zip EDMONDS WA 98026 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: 4/26/2024 Submitted By: Amy Revelle Page 1 of 2 i CITY OF EDMONDS MyBuil.dingPermit.com Mechanical Application #1474963 - Lazarus, Gary Project Contact Company Name: Ballard Natural Gas Service Name: Amy Revelle Email: permits@ballardnaturalgas.com Address: 2027 196th St SW A101 Phone #: (206) 784-8101 Lynnwood WA 98036 Project Type Single Family Residential Activity Type Scope of Work Alteration Mechanical Project Name: Lazarus, Gary Description of Work: Installation of Mitsubishi Heat Pump Project Details HVAC Systems Heat Pump 1 Work Location Work Description/Location (example: 1 st floor, NE side of the home Master Bath, Garage) Page 2 of 2