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Application_2021-1402CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1033393 Applicant First Name Last Name Company Name Piyumika Fraser Number Street Apartment or Suite Number E-mail Address 10318 244th St Sw pappuhamy@yahoo.com City State Zip Phone Number Extension Edmonds WA 98020 2066969201 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 10318 244TH ST SW City Zip Code County Parcel Number EDMONDS 98020 27033600303800 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 Thomas G & Piyumika S Fraser Number Street Apartment or Suite Number 10318 244TH ST SW 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, 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: 10/12/2021 Submitted By: Piyumika Fraser Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1033393 Project Type Single Family Residential Project Details Drains Floor Drain Fixtures Bidet Shower, Tub or Combo Hot Water Heater Sinks Sink Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) Activity Type Alteration 2 1 1 1 2 Scope of Work Plumbing Master bathroom renovation Page 2 of 2