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Application_1012065CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1012065 Applicant First Name Last Name dana thomas Company Name R & D Plumbing LLC Number Street 1911 201 st pl sw Apartment or Suite Number E-mail Address danathomas01 @gmail.com City State Zip lynnwood WA 98036 Phone Number Extension 4253464065 Contractor Company Name R&D PLUMBING LLC Number Street 216 NE 174th Street Apartment or Suite Number City State Zip Shoreline WA 98155 Phone Number Extension (425) 346-4065 State License Number License Expiration Date RDPLUPL889KB 5/30/2022 UBI # E-mail Address BD:39D944s danathomas01 @gmail.com Project Location Number Street 224 SKYLINE DR Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00423000005900 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 Buell S & Cathy M Herzig Number Street 224 SKYLINE 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: 8/30/2021 Submitted By: dana thomas Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1012065 Project Type Single Family Residential Project Details Fixtures Ice Maker Toilet Sinks Sink Work Location Work Description/Location (example Master Bath, Garage) Activity Type Alteration 1 1 3 Scope of Work Plumbing 1 st floor, Powder bathroom addition, add bar sink with ice maker Page 2 of 2