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BLD2022-1673_Application_12.9.2022_11.33.08_AM_3261270CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1236428 - Water line replacement Applicant First Name Last Name Company Name Erin Greene Number Street Apartment or Suite Number E-mail Address 18508 90th Ave W eringreene30@gmail.com City State Zip Phone Number Extension Edmonds WA 98026 (253) 732-6564 Contractor Company Name OMNI CONTRACTING SOLUTIONS LLC Number Street Apartment or Suite Number 3726 Broadway Suite 301 City State Zip Phone Number Extension EVERETT WA 98201 (425)6104961 State License Number License Expiration Date UBI # E-mail Address OMNICCS871 M4 7/24/2023 F;ni ii 4D74 Chris@omnics.com Project Location Number Street Floor Number Suite or Room Number 18508 90TH AVE W City Zip Code County Parcel Number EDMONDS 98026 00638500000400 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 Justin R Greene Number Street Apartment or Suite Number 18508 90TH AVE W City State Zip EDMONDS WA 98026-5715 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: 12/9/2022 Submitted By: Erin Greene Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1236428 - Water line replacement Project Contact Company Name: Name: Address: Erin Greene 18508 90th Ave W Edmonds WA 98026 Project Type Single Family Residential Email: eringreene30@gmail.com Phone #: (253) 732-6564 Activity Type Repair or Replacement Project Name: Water line replacement Description of Work: Water line replacement Project Details Scope of Work Like for like equipment in the same location Piping Water Line Re -Pipe Associated Building Permit? There is or will be a building permit associated with this work at the project location. Work Location Scope of Work Plumbing Work Description/Location (example: 1 st floor, Front yard (water line replacement starting from Meter Master Bath, Garage) and heading to to the house), and the Garage (where main line comes into the house). Page 2 of 2