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BLD2024-1460_Application_11.5.2024_1.35.24_PM_4602733CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1573976 - Fulton Applicant First Name Last Name Company Name Jeffrey Nelson MX Plumbing, Inc. Number Street Apartment or Suite Number E-mail Address 9646 15th PL SE mxplumbing@gmail.com City State Zip Phone Number Extension Lake Stevens WA 98258 (206) 818-1187 Contractor Company Name MX PLUMBING INC Number Street Apartment or Suite Number 9646 15th PL SE City State Zip Phone Number Extension Lake Stevens WA 98258 (206) 818-1187 State License Number License Expiration Date UBI # E-mail Address MXPLUP1777JJ 4/21/2025 FDiD9.1847 mxplumbing@gmail.com Project Location Number Street Floor Number Suite or Room Number 321 ERBEN DR City Zip Code County Parcel Number EDMONDS 98020 00409600101100 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 Jay A & Merri Keefer Fulton Number Street Apartment or Suite Number 7628 222ND ST SW A3 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: 11/5/2024 Submitted By: Jeffrey Nelson Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1573976 - Fulton Project Contact Company Name: MX Plumbing, Inc. Name: Jeffrey Nelson Email: mxplumbing@gmail.com Address: 9646 15th PL SE Phone #: (206) 818-1187 Lake Stevens WA 98258 Project Type Single Family Residential Activity Type Scope of Work New Plumbing Project Name: Fulton Description of Work: New Residential House/Plumbing Project Details Scope of Work Plumbing Fixtures for Building Permit Fixtures Clothes Washer Dishwasher Hose Bib Shower, Tub or Combo Toilet Hot Water Heater Sinks Sink Other Funnel Drain Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) Existing Permits There is or will be a building permit associated with this work at the project location. 1 1 2 2 3 1 Aq 1 New Residential House Page 2 of 2