Application_1597427CITY OF EDMONDS MyBuildingPermit.com
Mechanical Application #1597427
Applicant
First Name Last Name Company Name
Homage Senior Services Minor Home Repair Homage Senior Services
Number Street Apartment or Suite Number E-mail Address
5026 196th St SW MHR homerepair@homage.org
City State Zip Phone Number Extension
Lynnwood WA 98036 (425) 265-2222
Contractor
Company Name
SENIOR SERVICES/SNOHOMISH CNTY
Number Street Apartment or Suite Number
5026 196th St SW M H R
City State Zip Phone Number Extension
Lynnwood WA 98204 (425) 265-2222 (425) 514-3180
State License Number License Expiration Date UBI # E-mail Address
SENIOSS2430H 1/20/2026 Bnnnq_rggq homerepair@homage.org
Project Location
Number Street Floor Number Suite or Room Number
9721 238TH ST SW
City Zip Code County Parcel Number
EDMONDS 98020 00446300001000
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
Steven Bucklin
Number Street Apartment or Suite Number
9721 238TH ST SW
City State Zip
EDMONDS WA 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: 1/6/2025 Submitted By: Homage Senior Services Minor Home
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CITY OF EDMONDS MyBuildingPermit.com
Mechanical Application #1597427
Project Type
Single Family Residential
Project Details
HVAC Systems
Furnace
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, R & R GAS FURNACE LOCATED IN CLOSET
Master Bath, Garage) BUCKLIN, STEVEN // 54802-C
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