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BLD2022-0311_Application_3.10.2022_4.14.35_PM_2731074CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1105875 - Remove broken pipe & cap Applicant First Name Last Name Company Name Donna Coates Parkview Firs Condominiums Number Street Apartment or Suite Number E-mail Address 8421 Main Street bodpvf@gmail.com City State Zip Phone Number Extension Edmonds WA 98026 6502451768 Contractor Company Name Contractor Unknown 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 8515 MAIN ST 102 City Zip Code County Parcel Number EDMONDS 98026 00647400110200 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 Bob De Dea Number Street Apartment or Suite Number 8515 MAIN ST 102 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. If acting as an authorized agent, I further certify that I have full power and authority to file this application and to perform, on behalf of the owner, all acts required to enable the jurisdiction to process and review such application. I have furnished true and correct information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of work requires a licensed contractor to perform the work, the information will be provided prior to permit issuance. Date Submitted: 3/10/2022 Submitted By: Donna Coates Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1105875 - Remove broken pipe & cap Project Contact Company Name: Parkview Firs Condominiums Name: Donna Coates Email: bodpvf@gmail.com Address: 8421 Main Street Phone #: 6502451768 Edmonds WA 98026 Project Type Multifamily Residential Activity Type Repair or Replacement Scope of Work Plumbing Project Name: Remove broken pipe & cap Description of Work: Removed pipe cracked during late December freeze, undetected until January 18, 2022 Project Details Associated Building Permit? There is or will be a building permit associated with this work at the project location. Additional Project Information Total number of fixtures being added or altered 1 Work Location Work Description/Location (example: 1 st floor, Back wall of Utility shed Master Bath, Garage) Work to be performed by a licensed contractor Yes Page 2 of 2