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Application_2021-0562CITY OF EDMONDS M BuildingPermit.com Plumbing Application #951106 Applicant First Name Last Name Company Name Jeff Stollwerck Stollwerck Plumbing & Sewer LLC Number Street Apartment or Suite Number E-mail Address 611 5th Street B jd@stollwerckplumbing.com City State Zip Phone Number Extension Mukilteo WA 98275 4253743909 Contractor Company Name Stollwerck Plumbing LLC Number Street Apartment or Suite Number 3906 68th Dr NE City State Zip Phone Number Extension Marysville WA 98270 (206) 302-8382 State License Number License Expiration Date UBI # E-mail Address STOLLPL880MC 8/5/2022 Fn.'19n 31 D4 jd@stollwerckplumbing.com Project Location Number Street Floor Number Suite or Room Number 18921 OLYMPIC VIEW DR City Zip Code County Parcel Number EDMONDS 98020 00434600007702 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 Jeffrey P & Colleen S Gebhardt Number Street Apartment or Suite Number 18921 OLYMPIC VIEW DR 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: 4/19/2021 Submitted By: Jeff Stollwerck Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #951106 Project Type Activity Type Scope of Work Single Family Residential Alteration Plumbing Project Details Fixtures Shower, Tub or Combo 1 Work Location Work Description/Location (example: 1st floor, Bathroom Master Bath, Garage) Page 2 of 2