Application_1158593CITY OF EDMONDS M BuildingPermit.com
Plumbing Application #1158593
Applicant
First Name Last Name Company Name
Kevin Stively
Number Street Apartment or Suite Number E-mail Address
9215 Sierra Street charla@thedraindoctors.net
City State Zip Phone Number Extension
Edmonds WA 98020 (425) 977-3098
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
9215 SIERRA ST
City Zip Code County Parcel Number
EDMONDS 98020 00572800000400
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
Kevin H & Mary F Cline Stively
Number Street Apartment or Suite Number
9215 SIERRA ST
City State Zip
EDMONDS WA 98020-2925
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: 6/14/2022 Submitted By: Kevin Stively
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CITY OF EDMONDS MyBuildingPermit.com
Plumbing Application #1158593
Project Type
Single Family Residential
Project Details
Fixtures
Hose Bib
Piping
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, repair waterline from house to meter
Master Bath, Garage)
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