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Application_1073695CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1073695 Applicant First Name Last Name Company Name Karen Matheney Washington Energy Services Company, LLC Number Street Apartment or Suite Number E-mail Address 3909 196th St SW permits@washingtonenergy.com City State Zip Phone Number Extension Lynnwood WA 98036 2063786648 Contractor Company Name WASHINGTON ENERGY SVCS CO LLC Number Street Apartment or Suite Number 3909 196th St SW City State Zip Phone Number Extension Lynnwood WA 98036 (206) 378-6648 State License Number License Expiration Date UBI # E-mail Address WASHIES796NU 10/25/2023 Fini.r;97ni9 permits@washingtonenergy.com Project Location Number Street Floor Number Suite or Room Number 22810 96TH PL W City Zip Code County Parcel Number EDMONDS 98020 00937900000500 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 Ingmar & Kirsten Ellenberger Number Street Apartment or Suite Number 4353 136TH PL SE City State Zip BELLEVUE WA 98006 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: 1/7/2022 Submitted By: Karen Matheney Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1073695 Project Type Single Family Residential Project Details Fixtures Water Heater - Gas Mechanical Associated Building Permit? Activity Type Repair or Replacement There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1st floor, 1ST FLOOR Master Bath, Garage) Scope of Work Plumbing Page 2 of 2