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Application_1085404CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1085404 Applicant First Name Last Name Shayli Sutton Company Name The Plumbing Physician Number Street PO Box 2213 Apartment or Suite Number E-mail Address plumbphy@aol.com City State Zip Lynnwood WA 98036 Phone Number Extension 4257716200 Contractor Company Name PLUMBING PHYSICIAN, THE Number Street PO Box 2213 Apartment or Suite Number City State Zip Lynnwood WA 98036 Phone Number Extension (425) 771-6200 State License Number License Expiration Date PLUMBP*792PD 10/1/2023 UBI # E-mail Address BD17(1f1917 plumbphy@aol.com Project Location Number Street 9323 216TH ST SW Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00545600000300 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 Jeremy Mitchell Number Street 9323 216TH ST SW 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: 2/1/2022 Submitted By: Shayli Sutton Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1085404 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Plumbing Project Details Scope of Work Like for like equipment in the same location Drains Floor Drain 1 Fixtures Clothes Washer 1 Dishwasher 1 Hose Bib 3 Ice Maker 1 Shower, Tub or Combo 3 Toilet 3 Water Heater - Gas Mechanical 1 Sinks Sink 4 Piping Gas Piping Outlets - Plum 1 Piping - Water Service Associated Building Permit? There is no other onsite work that requires a building permit. Other Back Water Valve 1 Work Location Work Description/Location (example: 1st floor, Repipe through entire house Master Bath, Garage) Page 2 of 2