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Application_1533819-1CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1533819 Applicant First Name Last Name Georgiy Abdulfaizov Company Name GEORGE GAS PIPING LLC Number Street 601 12th AVE NW Apartment or Suite Number E-mail Address E-4 georgegaspiping@gmail.com City State Zip Issaquah WA 98027 Phone Number Extension (425) 577-2452 Contractor Company Name GEORGE GAS PIPING LLC Number Street 601 12TH AVE NW E4 Apartment or Suite Number City State Zip ISSAQUAH WA 98027 Phone Number Extension (425) 577-2452 State License Number License Expiration Date GEORGGP849JQ 4/18/2026 UBI # E-mail Address F;n:3F;n7gnF; georgegaspiping@gmail.com Project Location Number Street 920 CAROL WAY Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00548900000707 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 Stacey A & Tamara J Grund Number Street 920 CAROL WAY Apartment or Suite Number City State EDMONDS WA Zip 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: 8/15/2024 Submitted By: Georgiy Abdulfaizov Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1533819 Project Type Single Family Residential Project Details Appliances and Equipment Gas Piping Outlets - Mech Associated Building Permit? Activity Type Repair or Replacement There is no other onsite work that requires a building permit. Work Location Scope of Work Mechanical Work Description/Location (example: 1 st floor, New gas line from the gas meter along side of the Master Bath, Garage) house then underground gas line to the backyard for the outdoor girll. Page 2 of 2