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Application_1227529CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1227529 Applicant First Name Last Name Karen Matheney Company Name Washington Energy Services Company, LLC Number Street 3909 196th St SW Apartment or Suite Number E-mail Address permits@washingtonenergy.com City State Zip Lynnwood WA 98036 Phone Number Extension (206) 378-6648 Contractor Company Name WASHINGTON ENERGY SVCS CO LLC Number Street 3909 196th St SW Apartment or Suite Number City State Zip Lynnwood WA 98036 Phone Number Extension (206) 378-6648 State License Number License Expiration Date WASHIES851 NS 9/7/2023 UBI # E-mail Address F;ni..r;99n 9 permits@washingtonenergy.com Project Location Number Street 24110 105TH PL W Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00564900301300 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 Elizabeth Ford Number Street 24110 105TH PL W Apartment or Suite Number City State EDMONDS WA Zip 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: 11/9/2022 Submitted By: Karen Matheney Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1227529 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Mechanical Project Details HVAC Systems Furnace Work Location Work Description/Location (example: 1 st floor, 1 st floor Master Bath, Garage) Page 2 of 2