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Application_1165616CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1165616 Applicant First Name Last Name Company Name George Fox Number Street Apartment or Suite Number E-mail Address 2210 37th St. lorifox@mlfoxconstruction.com City State Zip Phone Number Extension Everett WA 98201 (425) 397-6965 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 317 ELM ST City Zip Code County Parcel Number EDMONDS 98020 00582000201002 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 Lori Fox Number Street Apartment or Suite Number 2210 37TH ST City State Zip EVERETT WA 98201-4509 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: 6/28/2022 Submitted By: George Fox Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1165616 Project Type Activity Type Scope of Work Single Family Residential New Plumbing Project Details Piping Piping - Water Service Water Supply Piping 1 Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1st floor, front yard Master Bath, Garage) Page 2 of 2