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BLD2024-0782_Application_6.12.2024_4.34.31_PM_4318589CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1503336 - BACKFLOW REPLACEMENT Applicant First Name Last Name Company Name Nicole Marinez Mike's Plumbing & Drain Cleaning Number Street Apartment or Suite Number E-mail Address 21010 70th Ave W info@mikesplumbinganddrain.com City State Zip Phone Number Extension Edmonds WA 98026-7202 (425) 775-0201 Contractor Company Name MIKES PLUMBING/DRAIN CLEANING Number Street Apartment or Suite Number 21010 70th Ave W City State Zip Phone Number Extension Edmonds WA 98026-7202 (425) 775-0201 State License Number License Expiration Date UBI # E-mail Address mikespc990km 12/5/2025 FD9114:3DR info@mikespiumbinganddrain.com Project Location Number Street Floor Number Suite or Room Number 21020 70TH AVE W Building Building City Zip Code County Parcel Number EDMONDS 98026 00566900600106 Associated Building Permit Number Tenant Name Thermal Products Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name CRE PROPERTIES LLC Number Street Apartment or Suite Number 17409 BEACH DR NE City State Zip LAKE FORREST WA 98155 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: 6/12/2024 Submitted By: Nicole Marinez Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1503336 - BACKFLOW REPLACEMENT Project Contact Company Name: Mike's Plumbing & Drain Cleaning Name: Nicole Marinez Email: info@mikesplumbinganddrain.com Address: 21010 70th Ave W Phone #: (425) 775-0201 Edmonds WA 98026-7202 Project Type Activity Type Scope of Work Nonresidential Repair or Replacement Plumbing Project Name: BACKFLOW REPLACEMENT Description of Work: Replacing Backflow Project Details Scope of Work Like for like equipment in the same location Type of Use Work does NOT have med gas, commercial kitchen, food svc, lab, medical, or dental use. Associated Building Permit? There is no other onsite work that requires a building permit. Additional Project Information Total number of fixtures being added or altered Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) 1 Backflow Replacement Page 2 of 2