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BLD2024-0947_Application_7.22.2024_1.45.49_PM_4392810CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1521470 - Goodman remodel Applicant First Name Last Name Company Name William and Michelle Goodman Number Street Apartment or Suite Number E-mail Address 16624 72nd Ave W wmgoodman1@comcast.net City State Zip Phone Number Extension EDMONDS WA 98026-5100 (206) 719-1416 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 16624 72ND AVE W City Zip Code County Parcel Number EDMONDS 98026 00513100010502 Associated Building Permit Number Tenant Name BLD2023-1461 Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name William M & Michelle S Goodman Number Street Apartment or Suite Number 16624 72ND 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: 7/22/2024 Submitted By: William and Michelle Goodman Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1521470 - Goodman remodel Project Contact Company Name: Name: William and Michelle Email: wmgoodman1@comcast.net Goodman Address: 16624 72nd Ave W Phone #: (206) 719-1416 EDMONDS WA 98026-5100 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Plumbing Project Name: Goodman remodel Description of Work: Basement bathroom remodel Project Details Scope of Work Like for like equipment in the same location Fixtures Dishwasher 1 Shower, Tub or Combo 1 Toilet 1 Sinks Sink 1 Work Location Work Description/Location (example: 1 st floor, Remodel basement bathroom Master Bath, Garage) Existing Permits There is or will be a building permit associated with this work at the project location. Page 2 of 2