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Application_2021-0834CITY OF EDMONDS M BuildingPermit.com Plumbing Application #978751 Applicant First Name Last Name Company Name Dennis Hamon Gene Johnson Plumbing and Heating Number Street Apartment or Suite Number E-mail Address 10011 Greenwood Ave N gwen@genejohnsonplumbing.com City State Zip Phone Number Extension Seattle WA 98133 206-789-6610 Contractor Company Name GENE JOHNSON PLUMBING & HEATNG Number Street Apartment or Suite Number 10011 Greenwood Ave N City State Zip Phone Number Extension Seattle WA 98133 206-789-6610 State License Number License Expiration Date UBI # E-mail Address GENEJJP924RT 1/11/2023 BD9B7gDgq gwen@genejohnsonplumbing.com Project Location Number Street Floor Number Suite or Room Number 1226 7TH AVE S City Zip Code County Parcel Number EDMONDS 98020 27032500301600 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 Gary L Anderson Number Street Apartment or Suite Number 1226 7TH AVE S City State Zip EDMONDS WA 98020-6602 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: 6/16/2021 Submitted By: Dennis Hamon Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #978751 Project Type Activity Type Scope of Work Single Family Residential Alteration Plumbing Project Details Piping Back Flow Preventer Work Location Work Description/Location (example: 1st floor, Basement Master Bath, Garage) Page 2 of 2