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Application_1089519CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1089519 Applicant First Name Last Name Tom Gunderson Company Name Gunderson Plumbing LLC Number Street P.O. Box 1251 Apartment or Suite Number E-mail Address tomgundersonplumbing@gmail.com City State Zip Sultan WA 98294 Phone Number Extension (360)794-5335 Contractor Company Name GUNDERSON PLUMBING LLC Number Street PO BOX 1251 Apartment or Suite Number City State Zip SULTAN WA 98294 Phone Number Extension (360)794-5335 State License Number License Expiration Date GUNDEPL782BQ 1/5/2024 UBI # E-mail Address Bni49BBS_c, tomgundersonplumbing@gmail.com Project Location Number Street 115 SKYLINE DR Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00423000005500 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 Susannah Custodian Johnston Number Street FBO ZHOU YANGQIN 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: 2/8/2022 Submitted By: Tom Gunderson Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1089519 Project Type Single Family Residential Project Details Activity Type Repair or Replacement Scope of Work Like for like equipment in the same location Piping Piping - Water Service Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1st floor, Outside Master Bath, Garage) Scope of Work Plumbing Page 2 of 2