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FIR2023-0102+Application+10.11.2023_8.23.11_AM+3833872CITY OF EDMONDS MyBuildingPermit.com Fire Application #1388355 - Landsvrk Custom Home Applicant First Name Last Name Company Name Jerry Ford Water Works Plumbinq Inc Number Street Apartment or Suite Number E-mail Address 9006 172nd St. SE waterworksplumbinginc(D_outlook.com City State Zip Phone Number Extension Snohomish WA 98296 (425) 344-1694 Contractor Company Name Water Works Plumbinq Inc Number Street Apartment or Suite Number 9006 172nd St SE City State Zip Phone Number Extension Snohomish WA 98296 (425) 344-1694 State License Number License Expiration Date UBI # E-mail Address WATERWP011 NP 4/28/2025 601946834 waterworksplumbinginc(a�_outlook.com Project Location Number Street Floor Number Suite or Room Number 19515 94TH PL W City Zip Code County Parcel Number EDMONDS 98020 00434600005801 Associated Building Permit Number Tenant Name BLD 2023-1156 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name Duane & Deanne Landsverk Number Street Apartment or Suite Number 24113 56TH AVE W City State Zip MOUNTLAKE WA 98043 Certification Statement - The applicant states: I certify that I am the owner of this property or the owner's authorized agent. If acting as an authorized agent, I further certify that I have full power and authority to file this application and to perform, on behalf of the owner, all acts required to enable the jurisdiction to process and review such application. I have furnished true and correct information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of work requires a licensed contractor to perform the work, the information will be provided prior to permit issuance. Date Submitted: 10/11/2023 Submitted By: Jerry Ford Page 1 of 2 i CITY OF EDMONDS MyBui[di ngPerrnit.com Fire Application #1388355 - Landsvrk Custom Home Project Contact Company Name: Water Works Plumbing Inc Name: Jerry Ford Email: waterworksplumbinginc@outlook.com Address: 9006 172nd St. SE Phone #: (425) 344-1694 Snohomish WA 98296 Project Type Single Family Residential Activity Type Scope of Work New Fire Sprinkler Systems Project Name: Landsvrk Custom Home Description of Work: Install 37 new fire sprinkler heads in a new SFR flow through fire sprinkler system. Project Details Fire System Type NFPA 13D Contact Information Owner Email Address waterworksplumbinginc@outlook.com Page 2 of 2