Application_1419772CITY OF EDMONDS MyBuildingPermit.com
Mechanical Application #1419772
Applicant
First Name Last Name
greg percy
Company Name
hearthside and home Ilc
Number Street
4829 196th st sw
Apartment or Suite Number E-mail Address
d hearthsideandhome@yahoo.com
City State Zip
lynnwood WA 98036
Phone Number Extension
(425) 771-6434
Contractor
Company Name
hearthside and home Ilc
Number Street
4829 196th st sw
Apartment or Suite Number
d
City State Zip
lynnwood WA 98036
Phone Number Extension
(425) 771-6434
State License Number License Expiration Date
HEARTHL868BC 1/3/2024
UBI # E-mail Address
F ig15R1R hearthsideandhome@yahoo.com
Project Location
Number Street
10519 ALAN-A-DALE PL
Floor Number Suite or Room Number
City Zip Code
EDMONDS 98026
County Parcel Number
00571300202200
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
Carley R & Lee Jessica K Clark
Number Street
10519 ALAN A DALE PL
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: 12/20/2023 Submitted By: greg percy
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CITY OF EDMONDS MyBuildingPermit.com
Mechanical Application #1419772
Project Type Activity Type Scope of Work
Single Family Residential Alteration Mechanical
Project Details
Heaters
Fireplace Insert - Gas
Associated Building Permit?
There is no other onsite work that requires a building
permit.
Work Location
Work Description/Location (example: 1 st floor, Main floor, living room, masonry fireplace - install
Master Bath, Garage) natural gas, direct vent, fireplace insert and connect to
existing gas line.
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