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ENG2023-0374+Application+7.20.2023_4.57.42_PM+3680310CITY OF EDMONDS MyBuildingPermit.com Utilities Application #1351309 - 310 Daley Unit C SS 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 BLD2022-1326 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: 7/20/2023 Submitted By: Jacob Young Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Utilities Application #1351309 - 310 Daley Unit C SS 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 New Side Sewer Connection Project Name: 310 Daley Unit C SS Install 6" side sewer for Unit C in a four unit townhouse project. Units A, B, C and D to share a Description of common 6" side sewer along the northwest side of the units. A single Romac saddle Work: connection to the existing sewer main in Daley Street to the north is proposed for these four units per PLN2021-0074. Townhouse C to be built under building permit BLD2022-1326 and civil site improvements to be built under PLN2021-0074. Project Details Structure Type Single Family Dwelling Project Information Connection to City sewer service Page 2 of 2