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Application_1248660CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1248660 Applicant First Name Last Name Kelly Fox Company Name Damian John Construction LLC Number Street 12310 Highway 99 Apartment or Suite Number E-mail Address 110 admin@djinstallations.com City State Zip Everett WA 98204 Phone Number Extension (425) 322-5530 Contractor Company Name DAMIAN JOHN CONSTRUCTION LLC Number Street 12310 Highway 99 Apartment or Suite Number Suite 110 City State Zip Everett WA 98204 Phone Number Extension (425) 322-5530 State License Number License Expiration Date DAMIAJC875BG 1/7/2023 UBI # E-mail Address FD9g57gB9 admin@djinstallations.com Project Location Number Street 21616 92ND AVE W Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00373600701606 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 Glenn & Tamara Wattum Number Street 21616 92ND AVE W Apartment or Suite Number City State EDMONDS WA Zip 98020 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: 1/3/2023 Submitted By: Kelly Fox Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1248660 Project Type Activity Type Scope of Work Single Family Residential Alteration Mechanical Project Details Appliances and Equipment Gas Piping Outlets - Mech 1 Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1st floor, Kitchen Master Bath, Garage) Page 2 of 2