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Application_1373413CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1373413 Applicant First Name Last Name Jeffrey Ullerich Company Name Number Street 18416 88th Ave.W. Apartment or Suite Number E-mail Address jeffreyullerich139@gmail.com City State Zip Edmonds WA 98026 Phone Number Extension (425) 563-8567 Contractor Company Name PROTOCOL PLUMBING & SEWER Number Street 1624 Grove ST Apartment or Suite Number D2 City State Zip Marysville WA 98270 Phone Number Extension (425) 743-4940 State License Number License Expiration Date PROTOPS794PG 10/5/2025 UBI # E-mail Address F;n9F;7nns� jeffreyullerich139@gmail.com Project Location Number Street 18416 88TH AVE W Floor Number Suite or Room Number City Zip Code EDMONDS 98026 County Parcel Number 00434600003408 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 W Ullerich Number Street PO BOX 6084 Apartment or Suite Number City State EDMONDS WA Zip 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: 9/8/2023 Submitted By: Jeffrey Ullerich Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1373413 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 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, Front yard - water service line from the meter to the Master Bath, Garage) house -- 1" pex Page 2 of 2