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BLD2024-0451_Application_4.5.2024_11.12.28_AM_4179142CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1467867 - plumbing work 18230 Edmonds Applicant First Name Last Name Company Name Sofia Bolotin Number Street Apartment or Suite Number E-mail Address 18230 91stAve W Sofikland@gmail.com City State Zip Phone Number Extension Edmonds WA 98026 (425) 551-9193 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 18230 91 ST AVE W City Zip Code County Parcel Number EDMONDS 98026 27041800200300 Associated Building Permit Number Tenant Name BLD2023-0168 Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Sofia & Vladimir Bolotin Number Street Apartment or Suite Number 18230 91 ST AVE W City State Zip EDMONDS WA 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: 4/5/2024 Submitted By: Sofia Bolotin Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1467867 - plumbing work 18230 Edmonds Project Contact Company Name: Name: Address: Sofia Bolotin 18230 91 st Ave W Edmonds WA 98026 Project Type Single Family Residential Email: Sofikland@gmail.com Phone #: (425) 551-9193 Activity Type Scope of Work New Plumbing Project Name: plumbing work 18230 Edmonds Description of Work: plumbing work in house Project Details Scope of Work Plumbing Fixtures for Building Permit Fixtures Clothes Washer Dishwasher Ice Maker Shower, Tub or Combo Toilet Hot Water Heater Sinks Sink Piping Piping - Water Service Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) Existing Permits There is or will be a building permit associated with this work at the project location. 1 1 1 4 4 1 7 1 st floor, 2nd floor, laundry Page 2 of 2