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BLD2022-0611_Application_5.10.2022_10.46.32_AM_2859163CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1139968 - Lander Applicant First Name Last Name Company Name Heath Shockman A -List Plumbing Number Street Apartment or Suite Number E-mail Address 21133 22nd Ave W heath@alistplumbing.com City State Zip Phone Number Extension Lynnwood WA 98036 (206)734-8444 Contractor Company Name A - LIST PLUMBING Number Street Apartment or Suite Number 21133 22ND AVE W City State Zip Phone Number Extension LYNNWOOD WA 98036 (206)734-8444 State License Number License Expiration Date UBI # E-mail Address LISTPLP783DB 2/22/2024 BD45'i1746 heath@alistplumbing.com Project Location Number Street Floor Number Suite or Room Number 1204 VIEWLAND WAY City Zip Code County Parcel Number EDMONDS 98020 00729500001100 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 Lynn M & James M Landers Number Street Apartment or Suite Number 1204 VIEWLAND WAY 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: 5/10/2022 Submitted By: Heath Shockman Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1139968 - Lander Project Contact Company Name: A -List Plumbing Name: Heath Shockman Email: heath@alistplumbing.com Address: 21133 22nd Ave W Phone #: (206)734-8444 Lynnwood WA 98036 Project Type Activity Type Scope of Work Single Family Residential Alteration Plumbing Project Name: Lander Description of Work: Master bath plumbing Project Details Scope of Work Like for like equipment in the same location Fixtures Shower, Tub or Combo 2 Toilet 1 Sinks Sink 2 Associated Building Permit? There is or will be a building permit associated with this work at the project location. Work Location Work Description/Location (example: 1 st floor, Master bathroom Master Bath, Garage) Page 2 of 2