ENG2023-0462+Application+9.7.2023_5.19.38_PM+3770894CITY OF EDMONDS MyBuildingPermit.com
Utilities Application #1373162 - 310 Daley Unit B WM
Applicant
First Name Last Name Company Name
Jacob Younq Citizen Desiqn Collaborative
Number Street Apartment or Suite Number E-mail Address
10 Dravus Street jyounq('�Dcollaborativeco.com
City State Zip Phone Number Extension
Seattle WA 98109 (206) 535-7908
Contractor
Company Name
Contractor Unknown
Number Street
City
State License Number
Project Location
State Zip
License Expiration Date UBI #
Number Street
310 DALEY ST
City Zip Code County Parcel Number
EDMONDS 98020 00434202600101
Associated Building Permit Number Tenant Name
BLD2022-1325
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
Apartment or Suite Number
Phone Number Extension
E-mail Address
Floor Number Suite or Room Number
First Name Last Name or Company Name
Auqustus J Bukowski
Number Street Apartment or Suite Number
1516 9TH AVE N
City State Zip
EDMONDS WA 98020
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: 9/7/2023 Submitted By: Jacob Young
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CITY OF EDMONDS MyBuildingPermit.com
Utilities Application #1373162 - 310 Daley Unit B WM
Project Contact
Company Name: Citizen Design Collaborative
Name: Jacob Young Email: jyoung@collaborativeco.com
Address: 10 Dravus Street Phone #: (206) 535-7908
Seattle WA 98109
Project Type Activity Type Scope of Work
Single Family Residential Water Meter Domestic - Fire Combo
Project Name: 310 Daley Unit B WM
Description of Work: Reuse existing water meter for 1" combined fire/domestic service for a new
residential townhouse.
Project Details
Water Meter Type
Domestic and Fire Combo
Water Meter Size
Water meter 1.0
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