BLD2022-0238_Application_2.23.2022_12.42.41_PM_2698267CITY OF EDMONDS M BuildingPermit.com
Plumbing Application #1094663 - VOSBURGH, ROSLYN //3586-26C
Applicant
First Name Last Name Company Name
Homage Senior Services Minor Home Repair Homage Senior Services
Number Street Apartment or Suite Number E-mail Address
5026 196th St SW MHR homerepair@homage.org
City State Zip Phone Number Extension
Lynnwood WA 98036 4252652222
Contractor
Company Name
SENIOR SERVICES/SNOHOMISH CNTY
Number Street Apartment or Suite Number
5026 196th St SW M H R
City State Zip Phone Number Extension
Lynnwood WA 98204 (425) 265-2222 (_)
State License Number License Expiration Date UBI # E-mail Address
SENIOSS2430H 1/20/2024 F;nnnq_rggq
Project Location
Number Street Floor Number Suite or Room Number
1038 SPRAGUE ST
City Zip Code County Parcel Number
EDMONDS 98020 00434204201100
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
Roslyn Vosburgh
Number Street Apartment or Suite Number
1038 SPRAGUE ST
City State Zip
EDMONDS WA 98020
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: 2/23/2022 Submitted By: Homage Senior Services Minor Home
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CITY OF EDMONDS MyBuildingPermit.com
Plumbing Application #1094663 - VOSBURGH, ROSLYN //3586-26C
Project Contact
Company Name: Homage Senior Services
Name: Homage Senior Services Minor Email: homerepair@homage.org
Home Repair
Address: 5026 196th St SW MHR Phone #: 4252652222
Lynnwood WA 98036
Project Type
Single Family Residential
Activity Type
Alteration
Project Name: VOSBURGH, ROSLYN //3586-26C
Description of Work: R & R ELECTRIC HWT LOCATED INSIDE CLOSET
Project Details
Scope of Work
Plumbing Fixtures for Building Permit
Fixtures
Hot Water Heater
Associated Building Permit?
There is no other onsite work that requires a building
permit.
Work Location
Work Description/Location (example: 1st floor,
Master Bath, Garage)
1
Scope of Work
Plumbing
R & R ELECTRIC HWT LOCATED INSIDE CLOSET
VOSBURGH, ROSLYN // 3586-26C
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