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BLD2022-0334_Application_3.16.2022_8.32.09_PM_2742907CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1102691 - Remodel - Plumbing Applicant First Name Last Name Company Name Jason Duncombe Number Street Apartment or Suite Number E-mail Address 18426 79th PI W jdduncombe@gmail.com City State Zip Phone Number Extension Edmonds WA 98026 2062250478 Contractor Company Name Owner Number Street Apartment or Suite Number City State Zip Phone Number Extension State License Number License Expiration Date UBI # E-mail Address Project Location Number Street Floor Number Suite or Room Number 18426 79TH PL W City Zip Code County Parcel Number EDMONDS 98026 00471000000800 Associated Building Permit Number Tenant Name BLD2022-0076 Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Jason & Nasanzuu Duncombe Number Street Apartment or Suite Number 18426 79th PI W City State Zip Edmonds WA 98026 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: 3/16/2022 Submitted By: Jason Duncombe Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1102691 - Remodel - Plumbing Project Contact Company Name: Name: Address: Jason Duncombe 18426 79th PI W Edmonds WA 98026 Project Type Single Family Residential Email: jdduncombe@gmail.com Phone #: 2062250478 Activity Type Alteration Project Name: Remodel - Plumbing Description of Work: Plumbing for home remodel. Project Details Scope of Work Plumbing Fixtures for Building Permit Fixtures Clothes Washer Dishwasher Hose Bib Ice Maker Shower, Tub or Combo Toilet Hot Water Heater Sinks Sink Piping Gas Piping Outlets - Plum Associated Building Permit? There is or will be a building permit associated with this work at the project location. Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) 1 1 1 1 2 2 1 3 2 Scope of Work Plumbing 1 st floor bathroom/laundry room, 2nd floor kitchen and 3/4 bathroom Page 2 of 2