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Application_1405862CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1405862 Applicant First Name Last Name Joseph Xayamouangbo Company Name Bobs Heating and Air Conditioning Number Street 14148 NE 190th St Apartment or Suite Number E-mail Address jxayamouangbo@bobsheating.com City State Zip Woodinville WA 98072 Phone Number Extension (800) 840-3346 Contractor Company Name BOB'S HEATING & AIR CNDTNG LLC Number Street 14148 NE 190th St Apartment or Suite Number City State Zip Woodinville WA 98072 Phone Number Extension (800) 840-3346 State License Number License Expiration Date BOBSHHA853NQ 9/7/2025 UBI # E-mail Address BDi597n9R jxayamouangbo@bobsheating.com Project Location Number Street 21512 90TH AVE W Floor Number Suite or Room Number City Zip Code EDMONDS 98026 County Parcel Number 00560900000600 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 Robert M Bakker Number Street 21512 90TH AVE W Apartment or Suite Number City State EDMONDS WA Zip 98026-7315 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: 11/16/2023 Submitted By: Joseph Xayamouangbo Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1405862 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: 1st floor, Garage Master Bath, Garage) Page 2 of 2