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Application_2021-1555CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1050205 Applicant First Name Last Name Bryan Radcliff Company Name Day and Nite Plumbing and Htg Inc. Number Street 16614 13th AVE W Apartment or Suite Number E-mail Address bryan@dayandnite.net City State Zip Lynnwood WA 98037 Phone Number Extension (425) 775-6464 Contractor Company Name DAY & NITE PLUMBING & HTG INC Number Street 16614 13th AVE W Apartment or Suite Number City State Zip Lynnwood WA 98037 Phone Number Extension (425) 775-6464 State License Number License Expiration Date DAYNINP7950S 8/31/2023 UBI # E-mail Address BDDDR1g76 bryan@dayandnite.net Project Location Number Street 23111 76TH AVE W Floor Number Suite or Room Number City Zip Code EDMONDS 98026 County Parcel Number 00488800400201 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 Patrick & Kjersten Dubuque Number Street 23111 76TH AVE W Apartment or Suite Number City State EDMONDS WA Zip 98026-8703 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: 11/15/2021 Submitted By: Bryan Radcliff Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1050205 Project Type Single Family Residential Project Details Piping Piping - Water Service Water Supply Piping Associated Building Permit? Activity Type Repair or Replacement There is no other onsite work that requires a building permit. Work Location Scope of Work Plumbing Work Description/Location (example: 1 st floor, Replace existing private water service from the city Master Bath, Garage) meter to the home in the front yard. Page 2 of 2