Application_BLD2022-1445CITY OF EDMONDS M BuildingPermit.com
Plumbing Application #1218866
Applicant
First Name Last Name Company Name
Jim Coolbaugh
Number Street Apartment or Suite Number E-mail Address
823 Main St arkcool63@yahoo.com
City State Zip Phone Number Extension
Edmonds WA 98020 (206) 510-5482
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
823 MAIN ST
City Zip Code County Parcel Number
EDMONDS 98020 00434207803200
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
Margaret Pepin-Donat
Number Street Apartment or Suite Number
823 MAIN ST
City State Zip
EDMONDS WA 98020
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: 10/20/2022 Submitted By: Jim Coolbaugh
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CITY OF EDMONDS MyBuildingPermit.com
Plumbing Application #1218866
Project Type
Single Family Residential
Project Details
Activity Type
Repair or Replacement
Scope of Work
Like for like equipment in the same location
Piping
Piping - Water Service
Associated Building Permit?
There is no other onsite work that requires a building
permit.
Work Location
Scope of Work
Plumbing
Work Description/Location (example: 1 st floor, Exterior - waterline replacement
Master Bath, Garage)
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