ENG2023-0577+Application+11.7.2023_9.04.28_AM+3885230CITY OF EDMONDS
Utilities Application #1400560 - 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
SIGNATURE HMS BY VILL LIFE LLC
Number
Street
19020 33RD AVE W STE 450
City
State Zip
LYNNWOOD
WA 98036
State License Number
License Expiration Date UBI #
SIGNAHV788NC 8/2/2024 602977522
Project Location
Phone Number Extension
(425) 678-1465
Apartment or Suite Number
Phone Number Extension
(425) 778-4111
E-mail Address
austin(aD_villagedife.net
Number Street Floor Number Suite or Room Number
17606 72ND AVE W
City Zip Code County Parcel Number
EDMONDS 98026 00513600000100
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
Duncan & Stephanie Spence
Number Street Apartment or Suite Number
17606 72ND AVE W
City State Zip
EDMONDS WA 98026
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: 11/7/2023 Submitted By: Austin Anderson
Page 1 of 2
CITY OF EDMONDS MyBuildingPermit.com
Utilities Application #1400560 - 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 Utility Availability Water Main
Project Name: Spence
Description of Work: Water availability application lot 2 PLN20170057
Project Details
Structure Type
Single Family Dwelling
Project Information
Connection to City water service
Page 2 of 2