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BLD2025-0199_Application_2.10.2025_4.35.42_PM_4754982CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1612265 - WATER SERVICE LINE SPOT REPAIR Applicant First Name Last Name Company Name Nicole Marinez Mike's Plumbing & Drain Cleaning Number Street Apartment or Suite Number E-mail Address 21010 70th Ave W info@mikesplumbinganddrain.com City State Zip Phone Number Extension Edmonds WA 98026-7202 (425) 775-0201 Contractor Company Name MIKES PLUMBING/DRAIN CLEANING Number Street Apartment or Suite Number 21010 70th Ave W City State Zip Phone Number Extension Edmonds WA 98026-7202 (425) 775-0201 State License Number License Expiration Date UBI # E-mail Address MIKESPD795MO 12/1/2025 BD9114ins info@mikespiumbinganddrain.com Project Location Number Street Floor Number Suite or Room Number 21102 SHELL VALLEY RD City Zip Code County Parcel Number EDMONDS 98026 00649900003200 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 Jon & Colleen Toma Number Street Apartment or Suite Number 21102 SHELL VALLEY RD 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: 2/10/2025 Submitted By: Nicole Marinez Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1612265 - WATER SERVICE LINE SPOT REPAIR Project Contact Company Name: Mike's Plumbing & Drain Cleaning Name: Nicole Marinez Email: info@mikesplumbinganddrain.com Address: 21010 70th Ave W Phone #: (425) 775-0201 Edmonds WA 98026-7202 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Plumbing Project Name: WATER SERVICE LINE SPOT REPAIR Description of Work: Install up to 3ft of 1 in PEX pipe to repair leak in located area. Project Details Piping Piping - Water Service Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) Existing Permits There is no other onsite work that requires a building permit. Install up to 3ft of 1 in PEX pipe to repair leak in located area. Page 2 of 2