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Application_1035345CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1035345 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 9315 216TH ST SW City Zip Code County Parcel Number EDMONDS 98020 00545600000400 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 ELI FOX LLC Number Street Apartment or Suite Number 12011 MARINE VIEW DR City State Zip MUKILTEO 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: 10/14/2021 Submitted By: Nicole Marinez Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1035345 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Plumbing Project Details Piping Piping - Water Service Work Location Work Description/Location (example: 1 st floor, Meter to where water line enters home Master Bath, Garage) Page 2 of 2