ENG2024-0379+Application+7.25.2024_11.18.53_AM+4401560CITY OF EDMONDS MyBuildingPermit.com
Utilities Application #1523406 - Henson Remodel
Applicant
First Name Last Name Company Name
Jason Simonis Puqet Sound Planninq
Number Street Apartment or Suite Number E-mail Address
27624 44th pl s jason(�Dpugetsoundplan ninq.com
City State Zip Phone Number Extension
AUBURN WA 98001 (907) 440-9284
Contractor
Company Name
Contractor Unknown
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
23620 79TH AVE W
City Zip Code County Parcel Number
EDMONDS 98026 00424400000501
Associated Building Permit Number Tenant Name
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
First Name Last Name or Company Name
Marqaret Henson
Number Street Apartment or Suite Number
7019 14TH AVE NW
City State Zip
SEATTLE WA 98117
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: 7/25/2024 Submitted By: Jason Simonis
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CITY OF EDMONDS MyBuildingPermit.com
Utilities Application #1523406 - Henson Remodel
Project Contact
Company Name: Puget Sound Planning
Name: Jason Simonis Email: jason@pugetsoundplanning.com
Address: 27624 44th pl s Phone #: (907) 440-9284
AUBURN WA 98001
Project Type Activity Type Scope of Work
Single Family Residential Utility Modification Partial Line Replacement
Project Name: Henson Remodel
Description of Submit application for side sewer connection upgrage, per engineering department Jeff.
Work: Add aprpoximately 48' of new side sewer and connect to the existing house. Replace 4"
line with a new 6" to street frontage.
Project Details
Structure Type
Single Family Dwelling
Project Information
Replace
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