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Application_2021-0960CITY OF EDMONDS M BuildingPermit.com Plumbing Application #989594 Applicant First Name Last Name Company Name MIKE'S PLUMBING MIKE'S PLUMBING Number Street Apartment or Suite Number E-mail Address PO Box 1535 OFFICE@MIKESPLUMBINGANDDRAIN.0 City State Zip Phone Number Extension EDMONDS WA 98020 (425)775-0201 Contractor Company Name MIKES PLUMBING/DRAIN CLEANING Number Street Apartment or Suite Number PO Box 1535 City State Zip Phone Number Extension Edmonds WA 98020-1535 (425) 775-0201 State License Number License Expiration Date UBI # E-mail Address mikespc990km 5/12/2023 FD9114:3DR OFFICE@MIKESPLUMBINGANDDRAIN. Project Location Number Street Floor Number Suite or Room Number 415 3RD AVE N City Zip Code County Parcel Number EDMONDS 98020 00592200001600 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 Adam S & Summer N Lemieux Number Street Apartment or Suite Number 415 3RD AVE N City State Zip EDMONDS WA 98020-3111 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: 7/12/2021 Submitted By: MIKE'S PLUMBING Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #989594 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Plumbing Project Details Piping Water Supply Piping 1 Work Location Work Description/Location (example: 1 st floor, On property water service line repair Master Bath, Garage) Page 2 of 2