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Application_1167119CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1167119 Applicant First Name Last Name Company Name ROXY KROGH Fast Water Heater Company Number Street Apartment or Suite Number E-mail Address 11715 NORTH CREEK PARKWAY SOUTH C-106 rkrogh@FASTWATERHEATER.COM City State Zip Phone Number Extension BOTHELL WA 98011 (425) 636-7084 Contractor Company Name Fast Water Heater Company Number Street Apartment or Suite Number 11715 NORTH CREEK PARKWAY SOUTH C-106 City State Zip Phone Number Extension BOTHELL WA 98011 (425) 636-7084 State License Number License Expiration Date UBI # E-mail Address FASTWWH79901 10/1/2023 F;n9.sR4544 rkrogh@FASTWATERHEATER.COM Project Location Number Street Floor Number Suite or Room Number 23420 93RD AVE W City Zip Code County Parcel Number EDMONDS 98020 00572300100200 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 Brenda Marie Kent Number Street Apartment or Suite Number 23420 93RD PL W 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, 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: 6/30/2022 Submitted By: ROXY KROGH Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1167119 Project Type Single Family Residential Project Details Fixtures Hot Water Heater Associated Building Permit? Activity Type Repair or Replacement There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1st floor, Laundry Room Master Bath, Garage) Scope of Work Plumbing Page 2 of 2