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Application_1003359CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1003359 Applicant First Name Last Name Karen Matheney Company Name Washington Energy Services Company, LLC Number Street 3909 196th St SW Apartment or Suite Number E-mail Address permits@washingtonenergy.com City State Zip Lynnwood WA 98036 Phone Number Extension 2063786648 Contractor Company Name WASHINGTON ENERGY SVCS CO LLC Number Street 3909 196th St SW Apartment or Suite Number City State Zip Lynnwood WA 98036 Phone Number Extension (206) 378-6648 State License Number License Expiration Date WASHIES851 NS 9/7/2023 UBI # E-mail Address F;ni..r;99n 9 permits@washingtonenergy.com Project Location Number Street 22915 108TH AVE W Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00610500000800 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 Merri Lee & Lovgren Robert C Jacobs Number Street 22915 108TH AVE W 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: 8/9/2021 Submitted By: Karen Matheney Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1003359 Project Type Single Family Residential Project Details Fixtures Water Heater - Gas Mechanical Work Location Activity Type Repair or Replacement Work Description/Location (example: 1 st floor, 1ST FLOOR Master Bath, Garage) Scope of Work Plumbing Page 2 of 2