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ENG2024-0290+Application+6.11.2024_3.24.11_PM+4315567CITY OF EDMONDS Utilities Application #1482686 - Spence Applicant First Name Last Name Austin Anderson i MyBuitdingPermit.com Company Name Villaqe Life Number Street Apartment or Suite Number E-mail Address 19020 33rd Ave W 450 austin(L village-life.net City State Zip Lynnwood WA 98036 Contractor Company Name Contractor Unknown Number Street City State License Number Project Location State Zip License Expiration Date UBI # Number Street 17606 72ND AVE W City Zip Code EDMONDS 98026 Associated Building Permit Number BLD2023-1599 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Phone Number Extension (425) 678-1465 Apartment or Suite Number Phone Number Extension E-mail Address Floor Number Suite or Room Number County Parcel Number 00513600000102 Tenant Name Last Name or Company Name SIGNATURE HOMES BY VILLAGE LIFE LLC Number Street Apartment or Suite Number 19020 33RD AVE W 450 City State Zip LYNNWOOD WA 98036 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: 6/11/2024 Submitted By: Austin Anderson Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Utilities Application #1482686 - Spence Project Contact Company Name: Village Life Name: Austin Anderson Email: austin@village-life.net Address: 19020 33rd Ave W 450 Phone #: (425) 678-1465 Lynnwood WA 98036 Project Type Activity Type Scope of Work Single Family Residential Water Meter Domestic - Fire Combo Project Name: Spence Description of Work: water meter permit application for a single family residence Project Details Water Meter Type Domestic and Fire Combo Water Meter Size Water meter 1.0 Page 2 of 2