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Application_986301CITY OF EDMONDS M BuildingPermit.com Plumbing Application #986301 Applicant First Name Last Name Joshua Prochnow Company Name KING PLUMBING LLC Number Street Apartment or Suite Number 120 161 st St SE E-mail Address info@kingplumbing.co City State Zip Bothell WA 98012 Phone Number Extension 2623555334 Contractor Company Name KING PLUMBING LLC Number Street 120 161st St SE Apartment or Suite Number City State Zip Bothell WA 98012 Phone Number Extension 4253651673 State License Number License Expiration Date UBI # KINGPPL821JS 4/10/2022 FB4ggg41B E-mail Address info@kingplumbing.co Project Location Number Street 19009 83RD AVE W Floor Number Suite or Room Number City Zip Code County Parcel Number EDMONDS 98026 00481600501401 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 Stefania Ramos Number Street 19009 83rd Ave W Apartment or Suite Number City State Zip Edmonds WA 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: 7/6/2021 Submitted By: Joshua Prochnow Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #986301 Project Type Activity Type Scope of Work Single Family Residential Alteration Plumbing Project Details Fixtures Clothes Washer 1 Dishwasher 1 Hose Bib 1 Ice Maker 1 Shower, Tub or Combo 1 Toilet 1 Sinks Sink 2 Work Location Work Description/Location (example: 1st floor, Basement Master Bath, Garage) Page 2 of 2