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BLD2021-0928_Application_7.2.2021_12.08.16_PM_2281718RECEIVED SUBJECT TO FIELD INSPECTION. BLD2021-0928 APPROVED OTC, 2 FIXTURES ONLY Jul 02 2021 \ CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #986115 - 8422 - Swedish Edmonds Mammography Applicant First Name Last Name Company Name Brittney Higgins University Mechanical Contractors Number Street Apartment or Suite Number E-mail Address 11611 49th Place West bhiggins@umci.com City State Zip Phone Number Extension Mukilteo WA 98275 2067945703 Contractor Company Name UNIVERSITY MECH CONTR INC Number Street Apartment or Suite Number 11611 49th Place West City State Zip Phone Number Extension Mukilteo WA 98275 (206) 7945703 State License Number License Expiration Date UBI # E-mail Address UNIVMC*343N9 10/3/2022 57RD9517R bhiggins@umci.com Project Location Number Street Floor Number Suite or Room Number 7320 216TH ST SW 1 210 City Zip Code County Parcel Number EDMONDS 98026 00580700002901 Associated Building Permit Number Tenant Name Swedish Hospital Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name * PUBLIC HOSPITAL DISTRICT 2 SNOHOMISH CO Number Street Apartment or Suite Number 4710 196TH ST SW City State Zip LYNNWOOD WA 98036-5517 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: 7/2/2021 Submitted By: Brittney Higgins Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #986115 - 8422 - Swedish Edmonds Mammography Project Contact Company Name: University Mechanical Contractors Name: John Shine Email: jshine@umci.com Address: 11611 49th Place West Phone #: (206) 391-3285 Mukilteo WA 98275 Project Type Nonresidential Activity Type Alteration Scope of Work Plumbing Project Name: 8422 - Swedish Edmonds Mammography Description of Work: Demo one existing sink, cap plumbing in wall. Install new wall mounted sink and goose -neck faucet. Project Details Scope of Work Like for like equipment in the same location Type of Use Work includes commercial kitchen, food svc, med gas, lab, medical use, or dental use. Associated Building Permit? There is no other onsite work that requires a building permit. Additional Project Information Total number of fixtures being added or altered Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) 1 Suite 120 - Mammography Page 2 of 2