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BLD2022-0605_Application_5.9.2022_12.19.50_PM_2856243CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1139008 - Chip Applicant First Name Last Name Company Name ROBERT OZANNE Ozannecustom Number Street Apartment or Suite Number E-mail Address 11017 Gundersen In robert.ozanne@gmail.com City State Zip Phone Number Extension Burlington WA 98233 (425)238-0765 Contractor Company Name OZANNE CUSTOM LLC Number Street Apartment or Suite Number 11017 GUNDERSEN LN City State Zip Phone Number Extension Burlington WA 98233 (425)238-0765 State License Number License Expiration Date UBI # E-mail Address OZANNCL790QQ 11/18/2023 RD4R1g775 robert.ozanne@gmail.com Project Location Number Street Floor Number Suite or Room Number 1226 SKYLINE DR City Zip Code County Parcel Number EDMONDS 98020 00423000004600 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 Charles & Lindsey Frolich Number Street Apartment or Suite Number 1226 SKYLINE DR 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: 5/9/2022 Submitted By: ROBERT OZANNE Page 1 of 2 i CITY OF EDMONDS MyBuitdingPermit.com Plumbing Application #1139008 - Chip Project Contact Company Name: Ozannecustom Name: ROBERT OZANNE Email: robert.ozanne@gmail.com Address: 11017 Gundersen In Phone #: (425)238-0765 Burlington WA 98233 Project Type Single Family Residential Activity Type Scope of Work New Plumbing Project Name: Chip Description of Work: Installed short gas line from meter to future tankless and new gas furnace with a barbecue stub next to gas meter Project Details Scope of Work Plumbing Fixtures for Building Permit Fixtures Water Heater - Tankless Piping Gas Piping Outlets - Plum Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) 1 3 Installed gas pipe for barbecue future tankless hot water heater and gas furnace located on basement floor of house the test gage is located next to gas meter Page 2 of 2