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Application_2022-0673CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1146943 Applicant First Name Last Name Company Name Sue Lane Number Street Apartment or Suite Number E-mail Address 717 Pine St. katheryn@dirtcheapinc.com City State Zip Phone Number Extension Edmonds WA 98020 (425) 512-9652 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 717 PINE ST City Zip Code County Parcel Number EDMONDS 98020 27032500202300 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 Susan C Lane Number Street Apartment or Suite Number 717 PINE ST City State Zip EDMONDS WA 98020-4030 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: 5/23/2022 Submitted By: Sue Lane Page 1 of 2 i CITY OF EDMONDS MyBuitdingPermit.com Plumbing Application #1146943 Project Type Single Family Residential Project Details Activity Type Repair or Replacement Scope of Work Like for like equipment in the same location Piping Piping - Water Service Water Supply Piping Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Scope of Work Plumbing Work Description/Location (example: 1 st floor, Exterior of home from meter to house. Master Bath, Garage) Page 2 of 2