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Application_1387346CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1387346 Applicant First Name Last Name Company Name Kari Fleenor Number Street Apartment or Suite Number E-mail Address 20107 80th ave w karifleenor@gmail.com City State Zip Phone Number Extension Edmonds WA 98026 (425) 248-1563 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 20107 80TH AVE W City Zip Code County Parcel Number EDMONDS 98026 27041900109900 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 Kari & Fleenor Brian Fleenor Number Street Apartment or Suite Number 20107 80TH 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: 10/9/2023 Submitted By: Kari Fleenor Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1387346 Project Type Activity Type Scope of Work Single Family Residential Alteration Mechanical Project Details Appliances and Equipment Gas Piping Outlets - Mech 1 Work Location Work Description/Location (example: 1st floor, North Exterior side of the house Master Bath, Garage) Page 2 of 2