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Application_1071008CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1071008 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 info@mikesplumbinganddrain.com City State Zip Phone Number Extension EDMONDS WA 98020 4257750201 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 MIKESPD795MO 12/1/2023 BD9114ins info@mikespiumbinganddrain.com Project Location Number Street Floor Number Suite or Room Number 21705 80TH AVE W City Zip Code County Parcel Number EDMONDS 98026 00461000101103 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 Paige Brown Number Street Apartment or Suite Number 8818 CRESCENT BAR RD NW 21 City State Zip QU I NCY WA 98848 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: 1/3/2022 Submitted By: MIKE'S PLUMBING Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1071008 Project Type Single Family Residential Project Details Activity Type Repair or Replacement Scope of Work Like for like equipment in the same location Piping Piping - Water Service Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Scope of Work Plumbing Work Description/Location (example: 1 st floor, On property - meter to house Master Bath, Garage) Page 2 of 2