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Application_2021-0781CITY OF EDMONDS M BuildingPermit.com Plumbing Application #974602 Applicant First Name Last Name Company Name Mark Langford Number Street Apartment or Suite Number E-mail Address 211 5th Ave S. markl@intuitiveintegration.com City State Zip Phone Number Extension Edmonds WA 99020 2069199473 Contractor Company Name Owner Number Street Apartment or Suite Number City State Zip Phone Number Extension State License Number License Expiration Date UBI # E-mail Address Project Location Number Street Floor Number Suite or Room Number 211 5TH AVE N City Zip Code County Parcel Number EDMONDS 98020 00434400200300 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 Mark D & Marcella V Langford Number Street Apartment or Suite Number 211 5TH AVE N 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: 6/8/2021 Submitted By: Mark Langford Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #974602 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Plumbing Project Details Piping Piping - Water Service Work Location Work Description/Location (example: 1 st floor, 211 5th Ave Front yard to meter in side wall Master Bath, Garage) Page 2 of 2