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Application_2022-0159CITY OF EDMONDS MyBuildingPermitxom Mechanical Application #1088741 Applicant First Name Last Name gregory besancon Company Name NW Bathworks Number Street 18821 11th ave ne Apartment or Suite Number E-mail Address nwbathworks@gmail.com City State Zip Arlington WA 98223 Phone Number Extension (360)572-9308 Contractor Company Name NW BATHWORKS LLC Number Street 18821 11TH AVE NE Apartment or Suite Number City State Zip ARLINGTON WA 98223 Phone Number Extension 4254189545 State License Number License Expiration Date NWBATBL855PA 10/7/2023 UBI # E-mail Address BD.'15'1747D nwbathworks@gmail.com Project Location Number Street 1030 7TH AVE S Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00619400500300 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 Ryan & Weckenbrock Kristen Carson Number Street 1030 7TH AVE S 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: 2/7/2022 Submitted By: gregory besancon Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1088741 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Mechanical Project Details Heaters Heater - Gas Work Location Work Description/Location (example: 1st floor, GARAGE Master Bath, Garage) Page 2 of 2