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BLD2023-0912_Application_7.21.2023_10.49.29_AM_3681302CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1351577 - AFH remolding Applicant First Name Last Name Company Name Tsehay Ghebresilassie Number Street Apartment or Suite Number E-mail Address 8907 192nd st SW arseza2@yahoo.com City State Zip Phone Number Extension Edmonds WA 98026 (206) 330-3293 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 8907 192ND ST SW City Zip Code County Parcel Number EDMONDS 98026 00434600002811 Associated Building Permit Number Tenant Name BLD20221742 Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Tsehay Ghebresilassie Number Street Apartment or Suite Number 8907 192nd st SW City State Zip Edmonds Washington 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: 7/21/2023 Submitted By: Tsehay Ghebresilassie Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1351577 - AFH remolding Project Contact Company Name: Name: Tsehay Ghebresilassie Email: arseza2@yahoo.com Address: 8907 192nd st SW Phone #: (206) 330-3293 Edmonds WA 98026 Project Type Activity Type Single Family Residential New Project Name: AFH remolding Description of Work: remolding to AFH and upstairs Project Details Scope of Work Plumbing Fixtures for Building Permit Drains Floor Drain Fixtures Clothes Washer Dishwasher Ice Maker 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) 2 1 2 1 2 2 Scope of Work Plumbing upstairs and down stair bathroom down stair and bathroom upstairs 1 sink in upstairs and 1 sink downstairs in garage Page 2 of 2