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Application_1419552CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1419552 Applicant First Name Last Name Company Name Alan Schwartz Number Street Apartment or Suite Number E-mail Address 19211 93rd PL W alanschwartz@mac.com City State Zip Phone Number Extension Edmonds WA 98020 (425) 770-2144 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 19211 93RD PL W City Zip Code County Parcel Number EDMONDS 98020 00371100000800 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 Alan N Schwartz Number Street Apartment or Suite Number 19211 93RD PL W City State Zip EDMONDS WA 98020-2551 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: 12/20/2023 Submitted By: Alan Schwartz Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1419552 Project Type Single Family Residential Project Details Other natural gas log lighter Work Location Activity Type Repair or Replacement Work Description/Location (example: 1st floor, Fireplace in house Master Bath, Garage) Scope of Work Mechanical Page 2 of 2