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BLD2022-1190_Application_9.7.2022_11.42.44_AM_3094021CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1198455 - Hezer Plumbing Permit Applicant First Name Last Name Company Name Brett Herzer Number Street Apartment or Suite Number E-mail Address 16209 74th PI W bherzer@windermere.com City State Zip Phone Number Extension Edmonds WA 98026 (206) 261-7676 Contractor Company Name COMPLETE EXCAVATING LLC Number Street Apartment or Suite Number PO BOX 1275 City State Zip Phone Number Extension LAKE STEVENS WA 98258 (425) 346-7562 State License Number License Expiration Date UBI # E-mail Address COMPLEL82205 10/10/2022 FD4,vi19D4 justin@completeex.com Project Location Number Street Floor Number Suite or Room Number 16209 74TH PL W City Zip Code County Parcel Number EDMONDS 98026 00513100006600 Associated Building Permit Number Tenant Name PLN2021-0034 Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Brett H & Cheri M Herzer Number Street Apartment or Suite Number 16209 75TH PL 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: 9/7/2022 Submitted By: Brett Herzer Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1198455 - Hezer Plumbing Permit Project Contact Company Name: PLCet Sound Planning, Name: Lee Michaelis Address: 6100 219th St SW Suite 480 Mountlake Terrace WA 98043 Project Type Single Family Residential Email: lee.michaelis@pugetsoundplannin.com Phone #: (425) 830-1046 Activity Type Scope of Work New Plumbing Project Name: Hezer Plumbing Permit Description of Work: Disconnect water line for house located at 16213 74th PI W from house located at 16209 74th PI W and connect to new water meter applied for under ENG2022-0449. Project Details 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: 1 st floor, New water service line for an existing house that will be Master Bath, Garage) on Lot 2 of the Herzer Short Plat. New address for this lot is 16213 74th Ave W Page 2 of 2