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ENG2022-0151+Application+4.10.2022_7.51.23_AM+2792624CITY OF EDMONDS Utilities Application #1122065 - hugill Applicant First Name Last Name Sonya Moore Number Street Apartment or Suite Number PO Box 1009 City State Zip Marysville WA 98271 Contractor Company Name J E M CONSTRUCTION NW INC Number Street PO BOX 1009 City MARYSVI LLE State License Number JEMCON1007M7 Project Location Number Street City Associated Building Permit Number State Zip WA 98270-1009 License Expiration Date UBI # 10/4/2023 602005578 Zip Code Additional Information (i.e. equipment location or special instructions). Work Location 00488800700500 Property Owner First Name Number Street City State County Parcel Number Tenant Name Last Name or Company Name Certification Statement - The applicant states: Zip i MyBuitdingPermit.com Company Name J.E.M. CONSTRUCTION N.W., INC. E-mail Address jemconnwinc(.@_hotmail.com Phone Number Extension 3606522540 Apartment or Suite Number Phone Number Extension (360)652-2540 (206)455-5985 E-mail Address jemconnwinc(aD_hotmail.com Floor Number Suite or Room Number Apartment or Suite Number 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: 4/10/2022 Submitted By: Sonya Moore Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Utilities Application #1122065 - hugill Project Contact Company Name: J.E.M. CONSTRUCTION N.W., INC. Name: Sonya Moore Email: jemconnwinc@hotmail.com Address: PO Box 1009 Phone #: 3606522540 Marysville WA 98271 Project Type Single Family Residential Activity Type Scope of Work New Side Sewer Connection Project Name: hugill Description of Work: reconnect to sewer line Project Details Project Information Connection to City sewer service Page 2 of 2