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Application_1421615CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1421615 Applicant First Name Last Name Company Name MIKE'S PLUMBING MIKE'S PLUMBING Number Street Apartment or Suite Number E-mail Address PO Box 1535 info@mikesplumbinganddrain.com City State Zip Phone Number Extension EDMONDS WA 98020 (425) 775-0201 Contractor Company Name MIKES PLUMBING/DRAIN CLEANING Number Street Apartment or Suite Number PO Box 1535 City State Zip Phone Number Extension Edmonds WA 98020-1535 (425) 775-0201 State License Number License Expiration Date UBI # E-mail Address MIKESPD795MO 12/1/2025 BD9114ins info@mikespiumbinganddrain.com Project Location Number Street Floor Number Suite or Room Number 928 9TH AVE N City Zip Code County Parcel Number EDMONDS 98020 00670800000100 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 Ann Begert Number Street Apartment or Suite Number 928 9TH AVE N City State Zip EDMONDS WA 98020 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: 12/28/2023 Submitted By: MIKE'S PLUMBING Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1421615 Project Type Single Family Residential Project Details Piping Piping - Water Service Work Location Activity Type Repair or Replacement Work Description/Location (example: 1st floor, Master Bath, Garage) Existing Permits There is no other onsite work that requires a building permit. Scope of Work Plumbing Install up to 5ft PEX to repair leaking water line. Page 2 of 2