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BLD2021-1523_Application_11.9.2021_6.09.14_PM_2512028CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1047556 - Jackson/ Holmstad's Applicant First Name Last Name Company Name Barbara Selfridge Holmstad's Plumbing Inc. Number Street Apartment or Suite Number E-mail Address PO box 5635 barbaraselfridge@gmail.com City State Zip Phone Number Extension Everett WA 98206 (425) 259-9131 Contractor Company Name HOLMSTAD'S PLUMBING INC Number Street Apartment or Suite Number 2712 Coho Ln City State Zip Phone Number Extension ANACORTES WA 98221 3602021428 3602021428 State License Number License Expiration Date UBI # E-mail Address HOLMSP1005M9 3/10/2023 BDgD11174 barbaraselfridge@gmail.com Project Location Number Street Floor Number Suite or Room Number 18709 88TH AVE W n/a City Zip Code County Parcel Number EDMONDS 98026 00434600001604 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 John & Gail Jackson Number Street Apartment or Suite Number 7522 S TONGASS HW City State Zip KETCH ICAN AK 99901 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: 11/9/2021 Submitted By: Barbara Selfridge Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1047556 - Jackson/ Holmstad's Project Contact Company Name: Holmstad's Plumbing Inc. Name: BARBARA SELFRIDGE Email: barbaraselfridge@gmail.com Address: 2712 Coho Ln Phone #: 3602021428 ANACORTES WA 98221 Project Type Activity Type Scope of Work Single Family Condominium Unit Repair or Replacement Plumbing Project Name: Jackson/ Holmstad's Description of Work: repipe whole house repipe Project Details Scope of Work Like for like equipment in the same location Additional Project Information Total number of fixtures being added or altered 11 Work Location Work Description/Location (example: 1 st floor, 1 st floor repipe Master Bath, Garage) Page 2 of 2