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Application_1054505CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1054505 Applicant First Name Last Name Company Name Michaela Pollard King's Heating, Inc. Number Street Apartment or Suite Number E-mail Address 18933 HWY 99 contact@KingsHeating.com City State Zip Phone Number Extension Lynnwood WA 98036 4252755153 Contractor Company Name KING'S HEATING INC Number Street Apartment or Suite Number 18933 Highway 99 City State Zip Phone Number Extension Lynnwood WA 98036 (425) 275-5153 State License Number License Expiration Date UBI # E-mail Address KINGSH1044JA 3/10/2022 FD1 SR95g5 contact@KingsHeating.com Project Location Number Street Floor Number Suite or Room Number 24340 76TH AVE W City Zip Code County Parcel Number EDMONDS 98026 00491100001006 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 SEVENTY-SIXTH WEST LLC Number Street Apartment or Suite Number PO BOX 3247 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, 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: 11/23/2021 Submitted By: Michaela Pollard Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1054505 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement 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, Garage Master Bath, Garage) Page 2 of 2