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Application_2021-1514CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1045699 Applicant First Name Terry Last Name Clinton Company Name Fischer Plumbing Co Inc, The Number Street 6608 220th st sw Apartment or Suite Number E-mail Address fpdsl@nwlink.com City State Mountlake terrace WA Zip 98043 Phone Number Extension 2067834129 Contractor Company Name FISCHER HTG & A/C INC Number Street 6631 220th st Sw Apartment or Suite Number City Mountlake terrace State Zip WA 98036 Phone Number Extension (425) 406-3050 State License Number FISCHHC867NA License Expiration Date 8/10/2022 UBI # E-mail Address Fnmi 597R fpdsl@nwlink.com Project Location Number Street 17966 TALBOT RD Floor Number Suite or Room Number City EDMONDS Zip Code 98026 County Parcel Number 00594400004202 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name John T Last Name or Company Name Fosberg Number Street 17966 TALBOT RD Apartment or Suite Number City EDMONDS State WA Zip 98026-5327 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: 11/5/2021 Submitted By: Terry Clinton Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1045699 Project Type Activity Type Scope of Work Single Family Residential Alteration Mechanical Project Details HVAC Systems Furnace 1 Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) garage Page 2 of 2