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ENG2022-0336+Application+6.24.2022_12.34.47_PM+2953198CITY OF EDMONDS MyBuildingPermit.com Utilities Application #1164181 - Duffy Side Sewer Permit Applicant First Name Last Name Company Name Brian Duffy Number Street Apartment or Suite Number E-mail Address 23511 74th Ave W brianfduffy(abmsn.com City State Zip Phone Number Extension Edmonds WA 98026 (425) 830-1046 Contractor Company Name ENCORE CONSTRUCTION LLC Number Street Apartment or Suite Number 7910 123RD AVE NE City State Zip Phone Number Extension LAKE STEVENS WA 98258 4253599896 State License Number License Expiration Date UBI # E-mail Address ENCORCL857K6 12/14/2023 603507820 dlokhmatov(Dgmail.com Project Location Number Street Floor Number Suite or Room Number 23511 74TH AVE W City Zip Code County Parcel Number EDMONDS 98026 27043200200100 Associated Building Permit Number Tenant Name BLD2021-0578 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name Brian F & Nancy Duffy Number Street Apartment or Suite Number 23511 74TH AVE W City State Zip EDMONDS WA 98026-8500 Certification Statement - The applicant states: 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. 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: 6/24/2022 Submitted By: Brian Duffy Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Utilities Application #1164181 - Duffy Side Sewer Permit Project Contact Company Name: PLCet Sound Planning, Name: Lee Michaelis Email: lee.michaelis@pugetsoundplanning.com Address: 6100 219th St Phone #: (425) 830-1046 Mountlake Terrace WA 98043 Project Type Activity Type Scope of Work Single Family Residential Utility Modification Partial Line Replacement Project Name: Duffy Side Sewer Permit Description of Work: Install 6" clean out on existing side sewer line for future video inspection to be conducted by the city. Project Details Project Information Repair Page 2 of 2