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FIR2021-0074+Application+7.19.2021_3.36.55_PM+2309143CITY OF EDMONDS MyBuildingPermit.com Fire Application #993373 - Fire Sprinklers - Coons Residence Applicant First Name Last Name Company Name maureen robertson Lakeside Plumbinq & Heatinq, Inc. Number Street Apartment or Suite Number E-mail Address 17104 33rd Ave. N.E. PO Box 65266 lakesideph(.@_comcast.net City State Zip Phone Number Extension Seattle WA 98155 206-363-4513 Contractor Company Name LAKESIDE PLUMBING & HTG INC Number Street Apartment or Suite Number 17104 33rd Ave. N.E. PO Box 65266 City State Zip Phone Number Extension Seattle WA 98155 206-363-4513 State License Number License Expiration Date UBI # E-mail Address LAKESPH001 OA 9/1 /2021 602062777 lakesideph(c)-comcast.net Project Location Number Street Floor Number Suite or Room Number 8427 202ND ST SW City Zip Code County Parcel Number EDMONDS 98026 27041900207400 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 Mark E & Jennifer M Coons Number Street Apartment or Suite Number PO BOX 1025 City State Zip EDMONDS WA 98020 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: 7/19/2021 Submitted By: maureen robertson Page 1 of 2 i o CITY OF EDMONDS MyBaildingPerrnit.cm „c Fire Application #993373 - Fire Sprinklers - Coons Residence Project Contact Company Name: Lakeside Plumbing & Heating, Inc. Name: maureen robertson Email: lakesideph@comcast.net Address: 17104 33rd Ave. N.E. PO Box Phone #: 206-363-4513 65266 Seattle WA 98155 Project Type Activity Type Scope of Work Single Family Residential New Fire Sprinkler Systems Project Name: Fire Sprinklers - Coons Residence Description of Work: Installation of fire sprinkler system in new construction. Project Details Fire System Type NFPA 13D Page 2 of 2