BLD2021-0894_Application_6.26.2021_9.47.09_AM_2271091CITY OF EDMONDS M BuildingPermit.com
Plumbing Application #983091 - Water heater
Applicant
First Name Last Name Company Name
Nancy Ingham
Number Street Apartment or Suite Number E-mail Address
1130 5th Avenue S 300 nancyingham1259@aol.com
City State Zip Phone Number Extension
Edmonds WA 98020 2064090881
Contractor
Company Name
Contractor Unknown
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
1130 5TH AVE S 3 300
City Zip Code County Parcel Number
EDMONDS 98020 00691200130000
Associated Building Permit Number Tenant Name
Nancy Ingham
Additional Information (i.e. equipment location or special instructions)_
Work Location
Property Owner
First Name Last Name or Company Name
Nancy Ingham
Number Street Apartment or Suite Number
1130 5TH AVE S 300
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. If acting as an authorized agent, I further certify that I have full power and
authority to file this application and to perform, on behalf of the owner, all acts required to enable the jurisdiction to process and review such application. I
have furnished true and correct information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of work
requires a licensed contractor to perform the work, the information will be provided prior to permit issuance.
Date Submitted: 6/26/2021 Submitted By: Nancy Ingham
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CITY OF EDMONDS MyBuitdingPermit.com
Plumbing Application #983091 - Water heater
Project Contact
Company Name:
Name: Nancy Ingham Email: nancyingham1259@aol.com
Address: 1130 5th Avenue S 300 Phone #: 2064090881
Edmonds WA 98020
Project Type Activity Type
Multifamily Residential Repair or Replacement
Project Name: Water heater
Description of Work: Replacement of water heater
Project Details
Scope of Work
Like for like equipment in the same location
Associated Building Permit?
There is no other onsite work that requires a building
permit.
Work Location
Work Description/Location (example: 1 st floor, 3rd floor hall closet
Master Bath, Garage)
Work to be performed by a licensed contractor
Yes
Scope of Work
Plumbing
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