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BLD2024-1442_Application_11.1.2024_9.51.24_AM_4596365CITY OF EDMONDS M BuildingPermitxom Plumbing Application #1570292 - Cedar View New AFH Int Remodel Plumbing Applicant First Name Last Name Company Name Musse Bahta Cedar View AFH Number Street Apartment or Suite Number E-mail Address 8513 Madrona LN cedarviewafh23@gmail.com City State Zip Phone Number Extension EDMONDS WA 98026 (702) 423-0848 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 8513 MADRONA LN 1 NONE City Zip Code County Parcel Number EDMONDS 98026 00504700100600 Associated Building Permit Number Tenant Name BLD2024-0338 NEGHISTI BAHTA Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name *neghisti bahta CEDAR VIEW ADULT FAMILY HOME LLC Number Street Apartment or Suite Number 8513 MADRONA LANE 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: 11/1/2024 Submitted By: Musse Bahta Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1570292 - Cedar View New AFH Int Remodel Plumbing Project Contact Company Name: Cedar View AFH Name: Musse Bahta Email: cedarviewafh23@gmail.com Address: 8513 Madrona LN Phone #: (702) 423-0848 EDMONDs WA 98026 Project Type Activity Type Scope of Work Mixed Use New Plumbing Project Name: Cedar View New AFH Int Remodel Plumbing Description of Work: Plumbing for 4 bathrooms, 1 clothes washer and laundry sink Project Details Scope of Work Plumbing Fixtures for Building Permit Associated Building Permit? There is or will be a building permit associated with this work at the project location. Work Location Work Description/Location (example: 1 st floor, 1 st floor Master Bath, Garage) Work to be performed by a licensed contractor Yes Page 2 of 2