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Application_1343485CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1343485 Applicant First Name Last Name Company Name Lucile Rochester Number Street Apartment or Suite Number E-mail Address 21725 98th Ave W Itfoehammer@gmail.com City State Zip Phone Number Extension Edmonds WA 98020 (206) 947-9322 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 21725 98TH AVE W City Zip Code County Parcel Number EDMONDS 98020 00559700200600 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 Lucile M Rochester Number Street Apartment or Suite Number 21725 98TH AVE 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: 7/6/2023 Submitted By: Lucile Rochester Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1343485 Project Type Single Family Residential Project Details Activity Type Repair or Replacement Scope of Work Like for like equipment in the same location Piping Water Supply Piping 1 Associated Building Permit? There is no other onsite work that requires a building permit. Other Filter housing replacement 1 Work Location Work Description/Location (example: 1st floor, Garage Master Bath, Garage) Scope of Work Plumbing Page 2 of 2