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Application_2021-1101CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #994803 Applicant First Name Last Name Alisha Wilson Company Name Eagle Pipe & Mechanical Number Street 54 Seven Sisters Rd Apartment or Suite Number E-mail Address office@eaglepipemechanical.com City State Zip Port Ludlow WA 98365 Phone Number Extension 3603012943 Contractor Company Name Eagle Pipe & Mechanical LLC Number Street 54 Seven Sisters Rd Apartment or Suite Number City State Zip Port Ludlow WA 98365 Phone Number Extension (206) 765-6851 State License Number License Expiration Date EAGLEPM867LK 6/12/2022 UBI # E-mail Address RniggRl qq office@eaglepipemechanical.com Project Location Number Street 634 WALNUT ST Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00434209301100 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 Jeanna M Holtz Number Street 634 WALNUT ST 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: 7/22/2021 Submitted By: Alisha Wilson Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #994803 Project Type Activity Type Scope of Work Single Family Residential New Mechanical Project Details Heaters Fireplace Insert - Gas Work Location Work Description/Location (example: 1st floor, Living Room Master Bath, Garage) Page 2 of 2