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Application_2022-0453CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1121768 Applicant First Name Last Name Tyler taft Company Name Gene Johnson Plumbing and Heating Number Street 10011 Greenwood Ave N Apartment or Suite Number E-mail Address tyler@genejohnsonplumbing.com City State Zip Seattle WA 98133 Phone Number Extension 12067896610 Contractor Company Name GENE JOHNSON PLUMBING & HEATNG Number Street 10011 Greenwood Ave N Apartment or Suite Number City State Zip Seattle WA 98133 Phone Number Extension 2067896610 State License Number License Expiration Date GENEJJP79803 10/1/2023 UBI # E-mail Address BD9B7gDgq tyler@genejohnsonplumbing.com Project Location Number Street 8310 200TH ST SW Floor Number Suite or Room Number City Zip Code EDMONDS 98026 County Parcel Number 00431200000101 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 David Edwin Terry Number Street 8310 200TH ST SW Apartment or Suite Number City State EDMONDS WA Zip 98026-6735 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: 4/8/2022 Submitted By: Tyler taft Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1121768 Project Type Single Family Residential Project Details Piping Piping - Water Service Work Location Activity Type Repair or Replacement Scope of Work Plumbing Work Description/Location (example: 1 st floor, Waterline replacement from water meter to house Master Bath, Garage) Page 2 of 2