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Application_2021-1251CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1017112 Applicant First Name Mlchaela Last Name Pollard Company Name King's Heating, Inc. Number Street 18933 HWY 99 Apartment or Suite Number E-mail Address contact@KingsHeating.com City State Lynnwood WA Zip 98036 Phone Number Extension 4252755153 Contractor Company Name KINGS HEATING INC Number Street 18933 Highway 99 Apartment or Suite Number City Lynnwood State Zip WA 98036 Phone Number Extension (425) 275-5153 State License Number KINGSH1044JA License Expiration Date 3/10/2022 UBI # E-mail Address FD1 SR95g5 contact@KingsHeating.com Project Location Number Street 22109 95TH PL W Floor Number Suite or Room Number City EDMONDS Zip Code 98020 County Parcel Number 00544200200500 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Tom H Last Name or Company Name Haley Number Street 22109 95TH PL W Apartment or Suite Number City EDMONDS State WA Zip 98020-4519 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: 9/9/2021 Submitted By: Mlchaela Pollard Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1017112 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Mechanical Project Details HVAC Systems Furnace 1 Work Location Work Description/Location (example: 1st floor, Replace furnace in basement Master Bath, Garage) Page 2 of 2