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Application_1215196CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1215196 Applicant First Name Last Name Karen Matheney Company Name Washington Energy Services Company, LLC Number Street 3909 196th St SW Apartment or Suite Number E-mail Address permits@washingtonenergy.com City State Zip Lynnwood WA 98036 Phone Number Extension (206) 378-6648 Contractor Company Name WASHINGTON ENERGY SVCS CO LLC Number Street 3909 196th St SW Apartment or Suite Number City State Zip Lynnwood WA 98036 Phone Number Extension (206) 378-6648 State License Number License Expiration Date WASHIES796NU 10/25/2023 UBI # E-mail Address F;ni..r;99n 9 permits@washingtonenergy.com Project Location Number Street 20810 78TH AVE W Floor Number Suite or Room Number City Zip Code EDMONDS 98026 County Parcel Number 00595700001000 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 John I French Number Street 20810 78TH AVE W Apartment or Suite Number City State EDMONDS WA Zip 98026 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: 10/12/2022 Submitted By: Karen Matheney Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1215196 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