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Application_2021-1718CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1067461 Applicant First Name Last Name Company Name Karen Matheney Washington Energy Services Company, LLC Number Street Apartment or Suite Number E-mail Address 3909 196th St SW permits@washingtonenergy.com City State Zip Phone Number Extension Lynnwood WA 98036 2063786648 Contractor Company Name WASHINGTON ENERGY SVCS CO LLC Number Street Apartment or Suite Number 3909 196th St SW City State Zip Phone Number Extension Lynnwood WA 98036 (206) 378-6648 State License Number License Expiration Date UBI # E-mail Address WASHIES796NU 10/25/2023 Fini.r;97ni9 permits@washingtonenergy.com Project Location Number Street Floor Number Suite or Room Number 19218 84TH AVE W City Zip Code County Parcel Number EDMONDS 98026 27041800306300 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 Pete Cirkovich Number Street Apartment or Suite Number 19218 84TH AVE W 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: 12/21/2021 Submitted By: Karen Matheney Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1067461 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Plumbing Project Details Fixtures Water Heater - Gas Mechanical 1 Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) garage Page 2 of 2