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BLD2021-1249_Application_9.8.2021_2.59.55_PM_2398241CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1016779 - Hardie WH Applicant First Name Last Name Company Name Jerry Hardie Number Street Apartment or Suite Number E-mail Address 61 Pine St 303 jhardie1945@icloud.com City State Zip Phone Number Extension Edmonds WA 98020 4259410640 Contractor Company Name PROMAX WATER HEATERS & PLUMBNG Number Street Apartment or Suite Number 2620 BELLEVUE WAY NE City State Zip Phone Number Extension BELLEVUE WA 98004 4254951961 State License Number License Expiration Date UBI # E-mail Address PROMAWH804QR 11/12/2022 BD454g41 B jhardie1945@icloud.com Project Location Number Street Floor Number Suite or Room Number 51 PINE ST 208 City Zip Code County Parcel Number EDMONDS 98020 01022605120800 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 Jerry Steven & Rondel Hardie Number Street Apartment or Suite Number 51 PINE ST 208 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: 9/8/2021 Submitted By: Jerry Hardie Page 1 of 2 i CITY OF EDMONDS MyBuitdingPermit.com Plumbing Application #1016779 - Hardie WH Project Contact Company Name: Name: Address: Jerry Hardie 61 Pine St 303 Edmonds WA 98020 Project Type Single Family Condominium Unit Email: jhardie1945@icloud.com Phone #: 4259410640 Activity Type Scope of Work Repair or Replacement Plumbing Project Name: Hardie WH Description of Work: Replace 50 gal electric WH and Pressure Tank 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. Additional Project Information Total number of fixtures being added or altered Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) 1 install 50 gal electric WH and pressure tank Page 2 of 2