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Application_BLD2023-0109CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1259740 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 18111 69TH PL W City Zip Code County Parcel Number EDMONDS 98026 00906400001000 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 Adolfo M Sandoval Number Street Apartment or Suite Number 18111 69TH PL W City State Zip EDMONDS WA 98026-5611 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: 1/26/2023 Submitted By: MIKE'S PLUMBING Page 1 of 2 i CITY OF EDMONDS MyBuitdingPermit.com Plumbing Application #1259740 Project Type Single Family Residential Project Details Piping Piping - Water Service Associated Building Permit? Activity Type Repair or Replacement There is no other onsite work that requires a building permit. Work Location Scope of Work Plumbing Work Description/Location (example: 1 st floor, - Install up to 5ft of 1 in PEX to repair leaking water line Master Bath, Garage) in yard. Page 2 of 2