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BLD2023-0839_Application_7.6.2023_11.36.33_AM_3650413CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1343118 - Telema Applicant First Name Last Name Company Name Rey Romero Effective Plumbing Number Street Apartment or Suite Number E-mail Address 1957 P.O box 1957 effectiveplumbingllc425@gmail.com City State Zip Phone Number Extension Lynnwood WA 98036 (425) 772-4245 Contractor Company Name EFFECTIVE PLUMBING LLC Number Street Apartment or Suite Number 20232 38TH AVE W City State Zip Phone Number Extension LYNNWOOD WA 98036 (206) 406-5161 State License Number License Expiration Date UBI # E-mail Address EFFECPL792RO 1/14/2024 6644551 qq effectiveplumbingllc425@gmail.com Project Location Number Street Floor Number Suite or Room Number 24305 87TH PL W City Zip Code County Parcel Number EDMONDS 98026 00665900000500 Associated Building Permit Number Tenant Name BLD2021-0996 Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Waltengus T Talema Number Street Apartment or Suite Number 24305 87TH PL W City State Zip EDMONDS WA 98026-9005 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: 7/6/2023 Submitted By: Rey Romero Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1343118 - Telema Project Contact Company Name: Effective Plumbing Name: Rey Romero Email: effectiveplumbingllc425@gmail.com Address: 1957 P.O box 1957 Phone #: (425) 772-4245 Lynnwood WA 98036 Project Type Activity Type Scope of Work Single Family Residential Alteration Plumbing Project Name: Telema Description of Work: Add kitchen sink Project Details Scope of Work Plumbing Fixtures for Building Permit Sinks Sink 1 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, Interior Master Bath, Garage) Page 2 of 2