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BLD2025-0365_Application_3.14.2025_2.42.13_PM_4812213CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1626815 - Crafthaus Home Remodeling Applicant First Name Last Name Company Name Sam Teddy SJ TEDDY PLUMBING CNTRTRS LLC Number Street Apartment or Suite Number E-mail Address 9228 Goblin Ln sam@sjteddy.com City State Zip Phone Number Extension Everett WA 98208 (425) 241-5544 Contractor Company Name SJ TEDDY PLUMBING CNTRTRS LLC Number Street Apartment or Suite Number 9228 Goblin Ln City State Zip Phone Number Extension Everett WA 98208 (425) 241-5544 State License Number License Expiration Date UBI # E-mail Address SJTEDTP79OMN 7/13/2025 BD47514R.'I sam@sjteddy.com Project Location Number Street Floor Number Suite or Room Number 8520 188TH ST SW City Zip Code County Parcel Number EDMONDS 98026 00434600001903 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 Michael A & Anjanette N Ttees Grossman Number Street Apartment or Suite Number 17611 6TH AVE NW City State Zip SHORELINE WA 98177 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: 3/14/2025 Submitted By: Sam Teddy Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1626815 - Crafthaus Home Remodeling Project Contact Company Name: SJ TEDDY PLUMBING CNTRTRS LLC Name: Sam Teddy Email: sam@sjteddy.com Address: 9228 Goblin Ln Phone #: (425) 241-5544 Everett WA 98208 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Plumbing Project Name: Crafthaus Home Remodeling Description of Work: Moving some fixtures around in existing space Project Details Fixtures Shower, Tub or Combo 1 Toilet 1 Sinks Sink 3 Work Location Work Description/Location (example: 1 st floor, Master Bath, Kitchen Master Bath, Garage) Existing Permits There is or will be a building permit associated with this work at the project location. Page 2 of 2