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Application_1602045CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1602045 Applicant First Name Last Name Sam Teddy Company Name SJ TEDDY PLUMBING CNTRTRS LLC Number Street 9228 Goblin Ln Apartment or Suite Number E-mail Address sam@sjteddy.com City State Zip Everett WA 98208 Phone Number Extension (425) 241-5544 Contractor Company Name SJ TEDDY PLUMBING CNTRTRS LLC Number Street 9228 Goblin Ln Apartment or Suite Number City State Zip Everett WA 98208 Phone Number Extension (425) 241-5544 State License Number License Expiration Date SJTEDTP79OMN 7/13/2025 UBI # E-mail Address BD47514R� sam@sjteddy.com Project Location Number Street 734 FIR ST Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00619401001001 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 John\lena Kleven Number Street 734 FIR ST Apartment or Suite Number City State EDMONDS WA Zip 98020 Certification Statement - The applicant states: I certify that I am the owner of this property or the owner's authorized agent, including an appropriately licensed contractor. I have furnished true and correct information. I will comply with all provisions of law and ordinances governing this type of construction work, whether specific herein or not. By submitting this application I give the jurisdiction permission to enter the property to perform inspections. I understand that failure to comply with the above may result in revocation of the permit. Date Submitted: 1/16/2025 Submitted By: Sam Teddy Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1602045 Project Type Activity Type Scope of Work Single Family Residential New Plumbing Project Details Fixtures Shower, Tub or Combo Toilet Sinks Sink Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) Existing Permits There is no other onsite work that requires a building permit. 1 1 1 2nd floor added bathroom Page 2 of 2