Application_2022-0551CITY OF EDMONDS M BuildingPermit.com
Plumbing Application #1135272
Applicant
First Name Last Name Company Name
Gary Nelson
Number Street Apartment or Suite Number E-mail Address
923 Main Street kenhound@yahoo.com
City State Zip Phone Number Extension
Edmonds WA 98020 4254094767
Contractor
Company Name
Owner
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
923 MAIN ST
City Zip Code County Parcel Number
EDMONDS 98020 00434206700400
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
Geoffrey Nelson
Number Street Apartment or Suite Number
9710 WHARF ST
City State Zip
EDMONDS WA 98020-2363
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: 5/2/2022 Submitted By: Gary Nelson
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CITY OF EDMONDS MyBuildingPermit.com
Plumbing Application #1135272
Project Type
Single Family Residential
Project Details
Piping
Piping - Water Service
Water Supply Piping
Associated Building Permit?
Activity Type
Repair or Replacement
There is no other onsite work that requires a building
permit.
Work Location
Scope of Work
Plumbing
Work Description/Location (example: 1 st floor, Repair broken schedule 40 water Main.
Master Bath, Garage)
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