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Permit_1271582CITY OF EDMONDS Mechanical Permit My6uildingPermitxom Permit Information Permit Number RI n9n9'i-n91 A Issued Date 2/21/2023 Expiration Date 8/20/2023 Job Address 17627 69TH PL W Fee Paid $120.00 EDMONDS, 98026 Order Confirmation 1204637 Floor Related Permit# Suite Application ID 1271582 Contact Information Contact Name Kathleen Kappen Contractor BALLARD NATURAL GAS SRVC INC Phone Number (206) 784-8101 Property Owner Thomas H & Marla A Hughes LNI License# BALLANG062QD Address 17627 69TH PL W EDMONDS, WA Phone# (206) 784-8101 City Bus. License # 601506347 Property Owner Phone (425) 772-6660 Tenant Name Job Description A (Single Family Residential) (Repair or Replacement) Mechanical project involving ( 1 Heater - Gas, There is no other onsite work that requires a building permit.) 1 st floor Conditions - Post Permit on site. Do not cover until inspected. If the appliance is fuel burning, install a carbon monoxide alarm outside each sleeping area and on each level of the dwelling unit prior to the final inspection. Plumbing contractor license laws are regulated by Chapter 18.106 RCW. Property owners who hire an unlicensed plumber may assume the risks and potential monetary liability for work performed by unlicensed plumbing contractors. For more information contact L&I Department of Licensing at 1-800-647-0982. 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. Applicant: Kathleen Kappen Page 1 of 2 t of EDAf 0 1;�_-o CITY OF EDMONDS Mechanical Permit My6uildingPermitxom Permit Information Permit Number RI n9n9*i_n91Q Issued Date 2/21/2023 Expiration Date 8/20/2023 Job Address 17627 69TH PL W Fee Paid $120.00 EDMONDS, 98026 Order Confirmation 1204637 Floor Related Permit# Suite Application ID 1271582 Inspections Inspection IVR Inspector Date Inspection IVR Inspector Date Gas Test/Pipe Mech Rough -in Mechanical Final Inspection Scheduling The issuance of this permit in no way constitutes approval from any other agencies having regulatory authority over the facility and this construction activity. It is the responsibility of the property owner to obtain any and all such required approvals. Page 2 of 2