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BLD2022-0704_Application_5.27.2022_12.19.44_PM_2898552CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1150035 - Gas Lines Applicant First Name Last Name Company Name Angela Bahm Number Street Apartment or Suite Number E-mail Address 20320 81stAve W angiebahm@gmail.com City State Zip Phone Number Extension Edmonds WA 98026 (425) 232-5991 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 20320 81 ST AVE W City Zip Code County Parcel Number EDMONDS 98026 00431200001302 Associated Building Permit Number Tenant Name BLD2022-0666 Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Angela Bahm Number Street Apartment or Suite Number 20320 81 st Ave W City State Zip EDMONDS WA 98026 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: 5/27/2022 Submitted By: Angela Bahm Page 1 of 2 CITY OF EDMONDS Plumbing Application #1150035 - Gas Lines Project Contact Company Name: Name: Address: Angela Bahm 20320 81 st Ave W Edmonds WA 98026 Email: angiebahm@gmail.com Phone #: (425) 232-5991 i MyBuitdingPermit.com Project Type Activity Type Scope of Work Single Family Residential Alteration Plumbing Project Name: Gas Lines Description of Work: We are plumbing in an extension of the existing exterior line with 3 connections. One for a hot tub, one for an outdoor fire pit and one for an outdoor grill. Project Details Scope of Work Plumbing Fixtures for Building Permit Piping Gas Piping Outlets - Plum 3 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, Back patio Master Bath, Garage) Page 2 of 2