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Application_BLD2023-1096CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #1370823 Applicant First Name Last Name Company Name Bob Schneider Number Street Apartment or Suite Number E-mail Address 9918 242ND PL SW cbschneider@msn.com City State Zip Phone Number Extension edmonds WA 98020 (206) 833-0239 Contractor Company Name Owner Number Street Apartment or Suite Number City State Zip Phone Number Extension State License Number License Expiration Date UBI # E-mail Address Project Location Number Street Floor Number Suite or Room Number 9918 242ND PL SW City Zip Code County Parcel Number EDMONDS 98020 00746900000400 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 Robert A & Cynthia A Schneider Number Street Apartment or Suite Number 9918 242ND PL SW City State Zip EDMONDS WA 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: 9/1/2023 Submitted By: Bob Schneider Page 1 of 2 i CITY OF EDMONDS MyBuitdingPermit.com Mechanical Application #1370823 Project Type Single Family Residential Project Details Heaters Fireplace Insert - Gas Associated Building Permit? Activity Type Repair or Replacement There is or will be a building permit associated with this work at the project location. Work Location Scope of Work Mechanical Work Description/Location (example: 1st floor, replace existing insert in familyroom Master Bath, Garage) Page 2 of 2