ENG2023-0494_Application_9.27.2023_11.13.06_AM_3807270RECEIVED
CITY OF EDMONDS
Utilities Application #1381911 - Harris Duplex
/ Oct 09 2023
MyBuildingPermitxom CITY OF EDMONDS
DEVELOPMENT SERVICES
DEPARTMENT
Applicant
First Name Last Name Company Name
David Harris Dave Harris Enterprises LLC
Number Street Apartment or Suite Number E-mail Address
19702 20 ave nw harris.davidm@hotmail.com
City State Zip Phone Number Extension
Shoreline WA 98177 (206) 795-2009
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
21022 74TH AVE W
City Zip Code County Parcel Number
EDMONDS 98026 00566900400201
Associated Building Permit Number Tenant Name
BLD2020893
Additional Information (i.e. equipment location or special instructions)_
Work Location
Property Owner
First Name Last Name or Company Name
David M Harris
Number Street Apartment or Suite Number
19702 20TH AVE NW
City State Zip
SHORELINE WA 98177
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: 9/27/2023 Submitted By: David Harris
Page 1 of 2
CITY OF EDMONDS M BuildingPermit.com
Utilities Application #1381911 - Harris Duplex
Project Contact
Company Name: Dave Harris Enterprises LLC
Name: David Harris Email: harris.davidm@hotmail.com
Address: 19702 20 ave nw Phone #: (206) 795-2009
Shoreline WA 98177
Project Type Activity Type Scope of Work
Single Family Residential Utility Availability Water Main
Project Name: Harris Duplex
Description of Work: Water availabity
Project Details
Structure Type
Duplex
Project Information
Connection to City water service
Page 2 of 2