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BLD2025-0123_Application_1.28.2025_7.42.52_AM_4732050CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1606541 - Taylor Residence Applicant First Name Last Name Company Name Jordan Hackett Black Lion Heating and Air Conditioning Number Street Apartment or Suite Number E-mail Address 11001 118th pl ne info@blacklionhvac.com City State Zip Phone Number Extension KIRKLAND WA 98033 (425) 814-3944 Contractor Company Name BLACK LION HEATING & A/C LLC Number Street Apartment or Suite Number 11001 118th PL NE City State Zip Phone Number Extension KIRKLAND WA 98033 (425) 814-3944 State License Number License Expiration Date UBI # E-mail Address BLACKLH873QQ 11/18/2025 Rnimsggn info@blacklionhvac.com Project Location Number Street Floor Number Suite or Room Number 902 SEA VISTA PL City Zip Code County Parcel Number EDMONDS 98020 00637000001100 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 John & Jocelyne Taylor Number Street Apartment or Suite Number 902 SEA VISTA PL 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. 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: 1/28/2025 Submitted By: Jordan Hackett Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1606541 - Taylor Residence Project Contact Company Name: Black Lion Heating and Air Conditioning Name: Jordan Hackett Email: info@blacklionhvac.com Address: 11001 118th pl ne Phone #: (425) 814-3944 KIRKLAND WA 98033 Project Type Activity Type Single Family Residential Repair or Replacement Project Name: Taylor Residence Description of Work: installing an air handler, heat pump and water heater Project Details HVAC Systems Air Handler 10,000 CFM or less 1 Heat Pump 1 Other water heater 1 Work Location Work Description/Location (example: 1 st floor, garage/ side yard Master Bath, Garage) Scope of Work Mechanical Page 2 of 2