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Application_1277851CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1277851 Applicant First Name Last Name Company Name Tim Hamblen Hamblen & Sons Heating Number Street Apartment or Suite Number E-mail Address 7409 68TH AVE NE Hamblen.Sons@gmail.com City State Zip Phone Number Extension MARYSVILLE WA 98270 (425) 501-0123 Contractor Company Name HAMBLEN & SONS HEATING Number Street Apartment or Suite Number 7409 68TH AVE NE City State Zip Phone Number Extension MARYSVILLE WA 98270 (425) 501-0123 State License Number License Expiration Date UBI # E-mail Address HAMBLSH922DE 3/3/2024 BD14R1gBR Hamblen.Sons@gmail.com Project Location Number Street Floor Number Suite or Room Number 21726 97TH AVE W City Zip Code County Parcel Number EDMONDS 98020 00559700201100 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 Ray Ranstrom Number Street Apartment or Suite Number 21726 97TH AVE W City State Zip EDMONDS WA 98020-3955 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: 3/4/2023 Submitted By: Tim Hamblen Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1277851 Project Type Activity Type Scope of Work Single Family Residential Alteration Mechanical Project Details Appliances and Equipment Gas Piping Outlets - Mech Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1 st floor, Extend gas pipe —35' from meter through crawl space Master Bath, Garage) to support a new dual fuel range. Page 2 of 2