Application_BLD2022-1546CITY OF EDMONDS M BuildingPermit.com
Plumbing Application #1227818
Applicant
First Name Last Name
Roger Diaz
Company Name
JDA Plumbing LLC
Number Street
516 143rd St
Apartment or Suite Number E-mail Address
diguer38@gmail.com
City State Zip
Lynnwood WA 98087
Phone Number Extension
(425) 971-5802
Contractor
Company Name
JDA PLUMBING LLC
Number Street
17410 52ND AVE W
Apartment or Suite Number
City State Zip
LYNNWOOD WA 98037
Phone Number Extension
4259715802
State License Number License Expiration Date
JDAPLPL782J8 5/16/2024
UBI # E-mail Address
BD4,19fl9B� diguer38@gmail.com
Project Location
Number Street
10020 243RD PL SW
Floor Number Suite or Room Number
City Zip Code
EDMONDS 98020
County Parcel Number
00554900000100
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
Ilya Leonidovich Bolotin
Number Street
10020 243RD PL SW
Apartment or Suite Number
City State
EDMONDS WA
Zip
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: 11/9/2022 Submitted By: Roger Diaz
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CITY OF EDMONDS MyBuildingPermit.com
Plumbing Application #1227818
Project Type Activity Type Scope of Work
Single Family Residential Alteration Plumbing
Project Details
Scope of Work
Like for like equipment in the same location
Fixtures
Shower, Tub or Combo 1
Toilet 1
Sinks
Sink 1
Associated Building Permit?
There is no other onsite work that requires a building
permit.
Work Location
Work Description/Location (example: 1 st floor, We are remodeling a bathroom in the 1 st floor: Toilet,
Master Bath, Garage) sink and shower.
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