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Application_985198CITY OF EDMONDS M BuildingPermit.com Plumbing Application #985198 Applicant First Name jeffery Last Name poppe Company Name jqp jeffs quality plumbing Ilc Number Street 124 po box 1026 Apartment or Suite Number E-mail Address jefferypoppe410@yahoo.com City State orting WA Zip 98360 Phone Number Extension (253)230-5415 Contractor Company Name jqp jeffs quality plumbing Ilc Number Street 124 p.o. box 1026 Apartment or Suite Number City orting State Zip WA 98360 Phone Number Extension (360) 893-2408 State License Number JQPJEJQ866MJ License Expiration Date 7/11/2022 UBI # E-mail Address Rni4D:37F;.'1 jefferypoppe410@yahoo.com Project Location Number Street 1101 12TH AVE N Floor Number Suite or Room Number City EDMONDS Zip Code 98020 County Parcel Number 00548900001911 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Robert & Valerie Last Name or Company Name Margulis Number Street 1101 12TH AVE N Apartment or Suite Number City EDMONDS State 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: 6/30/2021 Submitted By: jeffery poppe Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #985198 Project Type Activity Type Scope of Work Single Family Residential Alteration Plumbing Project Details Fixtures Dishwasher 1 Ice Maker 1 Instant Hot water Tap 1 Sinks Sink 2 Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) kitchen Page 2 of 2