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Application_1211508CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1211508 Applicant First Name Last Name Company Name MIKE'S PLUMBING MIKE'S PLUMBING Number Street Apartment or Suite Number E-mail Address PO Box 1535 info@mikesplumbinganddrain.com City State Zip Phone Number Extension EDMONDS WA 98020 (425) 775-0201 Contractor Company Name MIKE'S PLUMBING & DRAIN CLNG Number Street Apartment or Suite Number PO Box 1535 City State Zip Phone Number Extension Edmonds WA 98020-1535 (425) 775-0201 State License Number License Expiration Date UBI # E-mail Address MIKESPD795MO 12/1/2023 BD9114ins info@mikespiumbinganddrain.com Project Location Number Street Floor Number Suite or Room Number 1315 OLYMPIC AVE City Zip Code County Parcel Number EDMONDS 98020 00548900000911 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 Crescentis Peri L & Philip W Di Number Street Apartment or Suite Number 1315 OLYMPIC AVE City State Zip EDMONDS WA 98020-2516 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: 10/5/2022 Submitted By: MIKE'S PLUMBING Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1211508 Project Type Activity Type Scope of Work Single Family Residential New Plumbing Project Details Piping Piping - Water Service Associated Building Permit? There is no other onsite work that requires a building permit. Work Location Work Description/Location (example: 1 st floor, Secondary line for hydrant Master Bath, Garage) Page 2 of 2