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Application_1506761CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1506761 Applicant First Name Last Name Company Name Amanda Shesterkin Renovate Construction, LLC Number Street Apartment or Suite Number E-mail Address 5608 17th Ave NW permits@renovatebuilt.com City State Zip Phone Number Extension Ballard WA 98107 (206) 715-4762 Contractor Company Name RENOVATE CONSTRUCTION LLC Number Street Apartment or Suite Number 1 300 NW 80th St Unit A City State Zip Phone Number Extension SEATTLE WA 98117 (206) 650-1287 State License Number License Expiration Date UBI # E-mail Address RENOVCL823PB 10/2/2024 F;uyis1 Rol permits@renovatebuilt.com Project Location Number Street Floor Number Suite or Room Number 21011 HILLCREST PL City Zip Code County Parcel Number EDMONDS 98026 00373600500610 Associated Building Permit Number Tenant Name BLD2024-0232 Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Gregory J & Madeline J Buchanan Number Street Apartment or Suite Number 21011 HILLCREST PL City State Zip EDMONDS WA 98026-6916 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: 6/27/2024 Submitted By: Amanda Shesterkin Page 1 of 2 i CITY OF EDMONDS MyBuitdingPermit.com Mechanical Application #1506761 Project Type Single Family Residential Project Details Heaters Fireplace Insert - Gas Associated Building Permit? Activity Type Repair or Replacement There is or will be a building permit associated with this work at the project location. Work Location Scope of Work Mechanical Work Description/Location (example: 1 st floor, Replace existing gas fireplace in living room with new Master Bath, Garage) gas fireplace Page 2 of 2