Application_1167328CITY OF EDMONDS M BuildingPermit.com
Plumbing Application #1167328
Applicant
First Name Last Name Company Name
Ron Sims Preview Group
Number Street Apartment or Suite Number E-mail Address
23230 76th Ave. W rongsims@comcast.net
City State Zip Phone Number Extension
Edmonds WA 98026 (206) 650-7594
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
23230 76TH AVE W
City Zip Code County Parcel Number
EDMONDS 98026 00576700001718
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
Ronald Sims
Number Street Apartment or Suite Number
23230 76TH AVE 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, 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: 6/30/2022 Submitted By: Ron Sims
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CITY OF EDMONDS MyBuitdingPermit.com
Plumbing Application #1167328
Project Type
Single Family Residential
Project Details
Piping
Piping - Water Service
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, about 1 foot out from my foundation in the front of my
Master Bath, Garage) house, the middle of the house
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