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BLD2024-1581_Application_12.3.2024_9.00.09_AM_4648736CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1585237 - water service Applicant First Name Last Name Company Name Heath Shockman A -List Plumbing LLC Number Street Apartment or Suite Number E-mail Address 19505 24 STE 104 admin@alistplumbing.com City State Zip Phone Number Extension Lynwood WA 98036 (206) 734-8444 Contractor Company Name A -List Plumbing LLC Number Street Apartment or Suite Number 21133 22nd Ave W City State Zip Phone Number Extension LYNNWOOD WA 98036 (206) 734-8444 State License Number License Expiration Date UBI # E-mail Address LISTPPL774Q8 12/18/2025 FD4g79F;97 admin@alistplumbing.com Project Location Number Street Floor Number Suite or Room Number 1123 9TH AVE S City Zip Code County Parcel Number EDMONDS 98020 27032500111100 Associated Building Permit Number Tenant Name water service Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Laurence & Monterey Robertson Number Street Apartment or Suite Number 1123 9TH AVE S City State Zip EDMONDS WA 98020-3963 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: 12/3/2024 Submitted By: Heath Shockman Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1585237 - water service Project Contact Company Name: A -List Plumbing LLC Name: Heath Shockman Email: admin@alistplumbing.com Address: 19505 24 STE 104 Phone #: (206) 734-8444 Lynwood WA 98036 Project Type Single Family Residential Project Name: water service Description of Work: water service Project Details Activity Type Repair or Replacement Piping Piping - Water Service Work Location Work Description/Location (example: 1st floor, driveway Master Bath, Garage) Existing Permits There is no other onsite work that requires a building permit. Scope of Work Plumbing Page 2 of 2