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BLD2021-0469_Application_4.2.2021_2.43.06_PM_2125419CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #944129 - MECH PERMIT Applicant First Name Last Name Company Name PERMIT COORDINATOR Blue Flame Htg Air & Electric Number Street Apartment or Suite Number E-mail Address 7116 220TH ST SW SUITE 1 INFO@BLUEFLAMECOMFORT.COM City State Zip Phone Number Extension MOUNTLAKE WA 98043 4257717139 Contractor Company Name RESCUE ROOTER Number Street Apartment or Suite Number 965 Ridge Lake Blvd Suite 201 City State Zip Phone Number Extension Memphis TN 38120 4257717139 State License Number License Expiration Date UBI # E-mail Address BLUEFFH825RM 12/31/2022 FD1 9'17g4q INFO@BLUEFLAMECOMFORT.COM Project Location Number Street Floor Number Suite or Room Number 22044 99TH PL W City Zip Code County Parcel Number EDMONDS 98020 00602100100600 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 Brian Michael Jzyk Number Street Apartment or Suite Number 22044 99TH PL W City State Zip EDMONDS WA 98020-4540 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: 4/2/2021 Submitted By: PERMIT COORDINATOR Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #944129 - MECH PERMIT Project Contact Company Name: Name: BRIAN JZYK Address: 22044 99TH PL W EDMONDS WA 98020 Email: THEJZYKS@GMAIL.COM Phone #: 2064194912 Project Type Activity Type Scope of Work Single Family Residential Alteration Mechanical Project Name: MECH PERMIT Description of Work: AC ADD Project Details HVAC Systems Air Conditioner 1 Work Location Work Description/Location (example: 1st floor, OUTSIDE Master Bath, Garage) Page 2 of 2