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BLD2023-0119_Application_1.30.2023_6.53.20_AM_3339499CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1261044 - Brousseau Applicant First Name Last Name Company Name ryan myers Ryan's Custom Plumbing Number Street Apartment or Suite Number E-mail Address 22529 73rd pl w ryanscustomplumbing@gmail.com City State Zip Phone Number Extension edmonds WA 98026 (425) 870-7960 Contractor Company Name RYAN'S CUSTOM PLUMBING INC Number Street Apartment or Suite Number 22529 73rd PI W City State Zip Phone Number Extension EDMONDS WA 98026 (425)870-7960 State License Number License Expiration Date UBI # E-mail Address RYANSCP784KB 5/23/2024 FD4,iA9517 ryanscustomplumbing@gmail.com Project Location Number Street Floor Number Suite or Room Number 24020 76TH AVE W City Zip Code County Parcel Number EDMONDS 98026 00491100000906 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 Tim R & Merrill M Brousseau Number Street Apartment or Suite Number 24020 76TH W City State Zip EDMONDS WA 98026 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: 1/30/2023 Submitted By: ryan myers Page 1 of 2 i CITY OF EDMONDS MyBuitdingPermit.com Plumbing Application #1261044 - Brousseau Project Contact Company Name: Ryan's Custom Plumbing Name: ryan myers Email: ryanscustomplumbing@gmail.com Address: 22529 73rd pl w Phone #: (425) 870-7960 edmonds WA 98026 Project Type Single Family Residential Project Name: Brousseau Description of Work: rough -in for new bathroom Project Details Activity Type Scope of Work New Plumbing Fixtures Shower, Tub or Combo Toilet Sinks Sink Associated Building Permit? There is or will be a building permit associated with this work at the project location. Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) 1 1 1 addition in back yard with one bathroom Page 2 of 2