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Application_1437638CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1437638 Applicant First Name Last Name Company Name Scott johnston Number Street Apartment or Suite Number E-mail Address 19403 80 Ave west s.johnston2789@gmail.com City State Zip Phone Number Extension Edmonds WA 98026 (425) 773-2941 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 19403 80TH AVE W City Zip Code County Parcel Number EDMONDS 98026 00390600000100 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 Vicki Jean Cook Number Street Apartment or Suite Number 19403 80TH AVE W City State Zip EDMONDS WA 98026-6212 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: 2/4/2024 Submitted By: scott johnston Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1437638 Project Type Single Family Residential Project Details Other Water line repair Work Location Activity Type Scope of Work Alteration Mechanical Work Description/Location (example: 1 st floor, Repairing leak on existing underground water supply Master Bath, Garage) from meter to house. Page 2 of 2