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Application_BLD2021-1171CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1196511 Applicant First Name Last Name Company Name Chad Schuster Number Street Apartment or Suite Number E-mail Address 17620 72nd Ave W chad8680@yahoo.com City State Zip Phone Number Extension Edmonds WA 98026 (206) 799-2574 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 17620 72ND AVE W City Zip Code County Parcel Number EDMONDS 98026 00513600000200 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 Chad & Kelly Schuster Number Street Apartment or Suite Number 17620 72ND 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, 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: 9/1/2022 Submitted By: Chad Schuster Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1196511 Project Type Activity Type Scope of Work Single Family Residential New Mechanical Project Details Appliances and Equipment Gas Piping Outlets - Mech Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1 st floor, Need permit for gas line connection from meter to Master Bath, Garage) house. Page 2 of 2