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BLD2025-0170_Application_2.4.2025_12.44.24_PM_4745174CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1609765 - Water Pipe repair Applicant First Name Last Name Company Name Jordan Jacobs Number Street Apartment or Suite Number E-mail Address 6828 174th Street Southwest jkjacobs21 @gmail.com City State Zip Phone Number Extension Edmonds WA 98026 (425) 466-6584 Contractor Company Name EFFECTIVE PLUMBING LLC Number Street Apartment or Suite Number 20232 38TH AVE W City State Zip Phone Number Extension LYNNWOOD WA 98036 (425) 772-4245 State License Number License Expiration Date UBI # E-mail Address EFFECPL792RO 1/14/2026 6644551qq jordanpj11@gmail.com Project Location Number Street Floor Number Suite or Room Number 6828 174TH ST SW City Zip Code County Parcel Number EDMONDS 98026 00513100014520 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 Jordan Jacobsen Number Street Apartment or Suite Number 6828 174TH ST SW 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: 2/4/2025 Submitted By: Jordan Jacobs Page 1 of 2 i CITY OF EDMONDS MyBuitdingPermit.com Plumbing Application #1609765 - Water Pipe repair Project Contact Company Name: Name: Jordan Jacobs Email: jkjacobs21 @gmail.com Address: 6828 174th Street Southwest Phone #: (425) 466-6584 Edmonds WA 98026 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Plumbing Project Name: Water Pipe repair Realized there was a leak from our water bill. Contacted Leak detection to come find the leak. Description of Determined it was between our house and water meter just outside of our garage. Plumber Work: came that day to repair because we were losing around 1000 gallons a day. We had to cover it back up because the snow projected for the weekend could have frozen the pipes. I have photos and receipts. Project Details Scope of Work Like for like equipment in the same location Piping Piping - Water Service Water Supply Piping 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 Water line repair between house and meter. Work completed 1/31. Put dirt back because we didn't want snow to cause any freezing over the weekend. I have photos and receipts. Page 2 of 2