Application_1512805CITY OF EDMONDS MyBuildingPermit.com
Mechanical Application #1512805
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 Ilc
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
1063 B AVE
Floor Number Suite or Room Number
City
EDMONDS
Zip Code
98020
County Parcel Number
00619400300602
Associated Building Permit Number
Tenant Name
Additional Information (i.e. equipment location or special
instructions)_
Work Location
Property Owner
First Name
Benjamin L & Jennifer M
Last Name or Company Name
Brackett
Number Street
1063 B AVE S
Apartment or Suite Number
City
EDMONDS
State
WA
Zip
98020
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: 7/3/2024 Submitted By: greg percy
Page 1 of 2
i
CITY OF EDMONDS MyBuitdingPermit.com
Mechanical Application #1512805
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: 1 st floor, Install direct vent gas insert into masonry fireplace
Master Bath, Garage) which has existing gas. Upstairs living room.
Page 2 of 2