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BLD2024-1614_Application_12.9.2024_9.40.43_AM_4659510CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1587796 - 12th ave house remodel - plumbing Applicant First Name Last Name Company Name Jesse Niebruegge Number Street Apartment or Suite Number E-mail Address 8608 236th st sw jesseniebs@gmail.com City State Zip Phone Number Extension Edmonds WA 98026 (206) 714-0941 Contractor Company Name Owner 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 341 12TH AVE N City Zip Code County Parcel Number EDMONDS 98020 00507200002000 Associated Building Permit Number Tenant Name BLD2024-0072 Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Jesse Reed & Bret Thomas Niebruegge Number Street Apartment or Suite Number 19209 OLYMPIC VIEW DR City State Zip EDMONDS WA 98020 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: 12/9/2024 Submitted By: Jesse Niebruegge Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1587796 - 12th ave house remodel - plumbing Project Contact Company Name: Name: Jesse Niebruegge Address: 19209 Olympic View Dr Edmonds Washington 98020 Project Type Single Family Residential Email: jesseniebs@gmail.com Phone #: (206) 714-0941 Activity Type Scope of Work New Plumbing Project Name: 12th ave house remodel - plumbing Description of Work: plumb the house as part of the remodel Project Details Scope of Work Plumbing Fixtures for Building Permit Fixtures Clothes Washer Dishwasher Hose Bib Ice Maker Instant Hot water Tap Shower, Tub or Combo Toilet Water Heater - Tankless Sinks Sink Piping Gas Piping Outlets - Plum 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. 2 1 3 1 1 4 4 1 7 3 whole house, as part of remodel permit Page 2 of 2