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Application_2021-1365CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1030087 Applicant First Name Last Name Company Name Mel Barber Number Street Apartment or Suite Number E-mail Address 7619 220th St SW melbarberl@gmail.com City State Zip Phone Number Extension Edmonds WA 98026 2067864491 Contractor Company Name Owner 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 7619 220TH ST SW City Zip Code County Parcel Number EDMONDS 98026 00461000201902 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 Robert W & Barber Rachel N Yanda Number Street Apartment or Suite Number 7619 220TH ST SW City State Zip EDMONDS WA 98026 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: 10/5/2021 Submitted By: Mel Barber Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1030087 Project Type Single Family Residential Project Details Fixtures Clothes Washer Dishwasher Shower, Tub or Combo Toilet Hot Water Heater Sinks Sink Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) Activity Type New 1 1 1 1 1 2 Scope of Work Plumbing detached garage - adding bathroom/laundry room and kitchen Page 2 of 2