BLD2024-0057_Application_1.13.2024_9.25.20_AM_3998605CITY OF EDMONDS M BuildingPermit.com
Plumbing Application #1428116 - Repair Water Supply
Applicant
First Name Last Name Company Name
Milniece Kerns
Number Street Apartment or Suite Number E-mail Address
24002 76th ave w Skootergryl@gmail.com
City State Zip Phone Number Extension
Edmonds WA 98026 (206) 229-3426
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
24002 76TH AVE W
City Zip Code County Parcel Number
EDMONDS 98026 00491100000916
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
Milniece B Kerns
Number Street Apartment or Suite Number
2711 E MASON LAKE DR E
City State Zip
GRAPEVIEW WA 98546
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: 1/13/2024 Submitted By: Milniece Kerns
Page 1 of 2
CITY OF EDMONDS MyBuildingPermit.com
Plumbing Application #1428116 - Repair Water Supply
Project Contact
Company Name:
Name:
Address:
Milniece Kerns
24002 76th ave w
Edmonds WA 98026
Project Type
Single Family Residential
Email: Skootergryl@gmail.com
Phone #: (206) 229-3426
Activity Type
Repair or Replacement
Project Name: Repair Water Supply
Description of Work: Repair leak in water supply line
Project Details
Scope of Work
Like for like equipment in the same location
Piping
Water Line Re -Pipe
Water Supply Piping
Other
Water supply repair
Work Location
Work Description/Location (example: 1st floor,
Master Bath, Garage)
Existing Permits
There is no other onsite work that requires a building
permit.
1
1
Scope of Work
Plumbing
Service pipe repair between meter and house
Page 2 of 2