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Application_1338305CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1338305 Applicant First Name Last Name Company Name Jeffrey Arbuckle Number Street Apartment or Suite Number E-mail Address 20111 80th Ave W. jt_buckle@yahoo.com City State Zip Phone Number Extension Edmonds WA 98026 (432) 386-3989 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 20111 80TH AVE W City Zip Code County Parcel Number EDMONDS 98026 27041900110100 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 Jeffrey T & Sarah D W Arbuckle Number Street Apartment or Suite Number 20111 80TH AVE 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, 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: 6/26/2023 Submitted By: Jeffrey Arbuckle Page 1 of 2 i CITY OF EDMONDS MyBuitdingPermit.com Plumbing Application #1338305 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 Water Supply Piping 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, Corner Of Lot, approximately 6' from meter location Master Bath, Garage) towards house Page 2 of 2