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FIR2024-0105+Application+10.23.2024_9.43.56_AM+4576180CITY OF EDMONDS MyBuildingPermit.com IF Fire Application #1565910 - Fuel Dock Operational Permit Applicant First Name Last Name Company Name Brandon Baker Port of Edmonds Number Street Apartment or Suite Number E-mail Address 471 Admiral Way bbaker(�Dportofedmonds.gov City State Zip Phone Number Extension Edmonds WA 98020 (425) 775-4588 Contractor Company Name Owner Number Street City State License Number Project Location State Zip License Expiration Date UBI # Number Street 471 ADMIRAL WAY City Zip Code County Parcel Number EDMONDS 98020 27032300415800 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Apartment or Suite Number Phone Number Extension E-mail Address Floor Number Suite or Room Number Fuel Dock First Name Last Name or Company Name EDMONDS PORT OF Number Street Apartment or Suite Number 458 ADMIRAL WAY City State Zip EDMONDS WA 98020 Certification Statement - The applicant states: 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. 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: 10/23/2024 Submitted By: Brandon Baker Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Fire Application #1565910 - Fuel Dock Operational Permit Project Contact Company Name: Port of Edmonds Name: Brandon Baker Email: bbaker@portofedmonds.gov Address: 471 Admiral Way Phone #: (425) 775-4588 Edmonds WA 98020 Project Type Activity Type Scope of Work Any Project Type Special Operational Permit Project Name: Fuel Dock Operational Permit Description of Work: Fuel Dock Operational Permit Project Details Type of Work Additional Project Information None of the above Event Description Event Description Contact Information Owner Email Address Fuel Dock Permit Fuel Dock Operational Permit bbaker@portofedmonds.gov Page 2 of 2