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Application_BLD2023-0838CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1343098 Applicant First Name Last Name Company Name John D Heys Number Street Apartment or Suite Number E-mail Address 20926 88th PL W dheys@msn.com City State Zip Phone Number Extension Edmonds WA 98026 (425) 275-1768 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 20926 88TH PL W City Zip Code County Parcel Number EDMONDS 98026 00373600500508 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 John D Heys Number Street Apartment or Suite Number 20926 88TH PL W City State Zip EDMONDS WA 98026-6906 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: 7/6/2023 Submitted By: John D Heys Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1343098 Project Type Activity Type Scope of Work Single Family Residential Alteration Plumbing Project Details Piping Gas Piping Outlets - Plum Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1 st floor, Installation of gas fireplace. Master Bath, Garage) Page 2 of 2