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BLD2021-0957_Application_7.12.2021_7.07.44_AM_2294012CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #989393 - Kienzle Residence Applicant First Name Last Name Company Name Greenwood Heating and AC Select Air Services DBA Greenwood Heating Number Street Apartment or Suite Number E-mail Address 825 S Stacy ST permits@greenwoodheating.com City State Zip Phone Number Extension Seattle WA 98134 2067841818 Contractor Company Name GREENWOOD HEATING & A/C Number Street Apartment or Suite Number 825 S STACY ST City State Zip Phone Number Extension Seattle WA 98134 (206) 784-1818 State License Number License Expiration Date UBI # E-mail Address GREENHA9221.17 2/3/2023 F;n99sgn14 permits@greenwoodheating.com Project Location Number Street Floor Number Suite or Room Number 17103 TALBOT RD City Zip Code County Parcel Number EDMONDS 98026 27040700104100 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 Doug Kienzle Number Street Apartment or Suite Number 17103 Talbot Rd City State Zip EDMONDS WA 98026 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: 7/12/2021 Submitted By: Greenwood Heating and AC Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #989393 - Kienzle Residence Project Contact Company Name: Select Air Services DBA Greenwood Heating Name: Greenwood Heating and AC Email: permits@greenwoodheating.com Address: 825 S Stacy ST Phone #: 2067841818 Seattle WA 98134 Project Type Single Family Residential Project Name: Kienzle Residence Description of Work: Install mini split Project Details Activity Type Scope of Work Alteration Mechanical HVAC Systems Heat Pump Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) 1 Exterior, master room, downstairs room Page 2 of 2