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Application_2021-0685CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #964508 Applicant First Name Last Name Arturas Gasparenas Company Name ART GAS PIPING LLC Number Street 4905 168th st SW Apartment or Suite Number E-mail Address D-102 artgaspiping@gmail.com City State Zip Lynnwood WA 98037 Phone Number Extension (206)434-9229 Contractor Company Name ART GAS PIPING LLC Number Street PO BOX 324 Apartment or Suite Number City State Zip MOUNTLAKE WA 98043 Phone Number Extension (206)434-9229 State License Number License Expiration Date ARTGAGP793CR 2/9/2023 UBI # E-mail Address FD4Bi5B9B artgaspiping@gmail.com Project Location Number Street 560 HOMELAND DR Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00477300001001 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 Susan Wainer Number Street 560 HOMELAND DR 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: 5/17/2021 Submitted By: Arturas Gasparenas Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #964508 Project Type Single Family Residential Project Details Appliances and Equipment Gas Piping Outlets - Mech Other Gas Range, Work Location Activity Type Scope of Work Alteration Mechanical Work Description/Location (example: 1st floor, 1st floor kitchen, Master Bath, Garage) Page 2 of 2