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Application_1043367CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1043367 Applicant First Name Last Name Jacob Markley Company Name Puget Sound Gas Works Number Street 2317 Twin PL Apartment or Suite Number E-mail Address pugetsoundgasworks@gmail.com City State Zip Anacortes WA 98221 Phone Number Extension 4253435566 Contractor Company Name PUGET SOUND GAS WORKS LLC Number Street 2317 TWIN PLACE Apartment or Suite Number City State Zip ANACORTES WA 98221 Phone Number Extension (425) 343-5566 State License Number License Expiration Date pugetsg851 n6 9/8/2023 UBI # E-mail Address Fn.i.r;7R7s� pugetsoundgasworks@gmail.com Project Location Number Street 627 GILTNER LN Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 27032400222600 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 Christopher A & Gutenplan Julie L Taffera Number Street 627 GILTNER LANE 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: 11/1/2021 Submitted By: Jacob Markley Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1043367 Project Type Activity Type Scope of Work Single Family Residential Alteration Mechanical Project Details Heaters Fireplace Insert - Gas Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1 st floor, We are running a gas line from the meter to a fireplace. Master Bath, Garage) Page 2 of 2