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BLD2021-1310_Application_9.23.2021_1.46.24_PM_2425678CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1024296 - WATER SERVICE REPLACEMENT Applicant First Name Last Name Company Name Nicole Marinez Marinez Plumbing, LLC Number Street Apartment or Suite Number E-mail Address PO Box 1535 mikes_plumbing@msn.com City State Zip Phone Number Extension Edmonds WA 98020-1535 (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 mikes_plumbing@msn.com Project Location Number Street Floor Number Suite or Room Number 8713 220TH ST SW outside outside City Zip Code County Parcel Number EDMONDS 98026 27043000203300 Associated Building Permit Number Tenant Name Dan Turnidge Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name OLYMPIC BAPTIST CHURCH - EDMONDS Number Street Apartment or Suite Number 8713 220TH ST SW City State Zip EDMONDS WA 98026-8133 Certification Statement - The applicant states: I certify that I am the owner of this property or the owner's authorized agent. If acting as an authorized agent, I further certify that I have full power and authority to file this application and to perform, on behalf of the owner, all acts required to enable the jurisdiction to process and review such application. I have furnished true and correct information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of work requires a licensed contractor to perform the work, the information will be provided prior to permit issuance. Date Submitted: 9/23/2021 Submitted By: Nicole Marinez Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1024296 - WATER SERVICE REPLACEMENT Project Contact Company Name: Name: Ryan Higgins Email: info@mikesplumbinganddrain.com Address: PO Box 1535 Phone #: 4257750201 Edmonds WA 98020 Project Type Activity Type Scope of Work Nonresidential Repair or Replacement Plumbing Project Name: WATER SERVICE REPLACEMENT Description of Work: Replace service line from meter to building. Project Details Type of Use Work does NOT have med gas, commercial kitchen, food svc, lab, medical, or dental use. Associated Building Permit? There is no other onsite work that requires a building permit. Additional Project Information Total number of fixtures being added or altered 1 Work Location Work Description/Location (example: 1st floor, Outside Master Bath, Garage) Page 2 of 2