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Application_2022-0074CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1079764 Applicant First Name Last Name Company Name Brett Bell Number Street Apartment or Suite Number E-mail Address 17521 72nd Ave W bellbrett@gmail.com City State Zip Phone Number Extension Edmonds WA 98026 8189158626 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 17521 72ND AVE W City Zip Code County Parcel Number EDMONDS 98026 00513100014303 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 Brett T & Diana L Bell Number Street Apartment or Suite Number 17521 72ND 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: 1/20/2022 Submitted By: Brett Bell Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1079764 Project Type Single Family Residential Project Details Piping Piping - Water Service Water Supply Piping Associated Building Permit? Activity Type Repair or Replacement There is no other onsite work that requires a building permit. Work Location Scope of Work Plumbing Work Description/Location (example: 1 st floor, repair is 10 feet south of meter inside fence Master Bath, Garage) Page 2 of 2