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Application_990921CITY OF EDMONDS M BuildingPermit.com Plumbing Application #990921 Applicant First Name Last Name Company Name Greta Visser Prima Plumbing Number Street Apartment or Suite Number E-mail Address 903 NW 50th St staff@primaplumbingnw.com City State Zip Phone Number Extension Seattle WA 98107 2067060300 Contractor Company Name Prima Plumbing Number Street Apartment or Suite Number 903 NW 50th St City State Zip Phone Number Extension Seattle WA 98107 (206) 706-0300 State License Number License Expiration Date UBI # E-mail Address PRIMAP*004J4 4/18/2023 RDgD9g97R staff@primaplumbingnw.com Project Location Number Street Floor Number Suite or Room Number 22050 99TH PL W City Zip Code County Parcel Number EDMONDS 98020 00602100100700 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 Delores Marvonek Number Street Apartment or Suite Number 5327 101 ST ST SW City State Zip MUKILTEO WA 98275-4307 Certification Statement - The applicant states: I certify that I am the owner of this property or the owner's authorized agent, including an appropriately licensed contractor. I have furnished true and correct information. I will comply with all provisions of law and ordinances governing this type of construction work, whether specific herein or not. By submitting this application I give the jurisdiction permission to enter the property to perform inspections. I understand that failure to comply with the above may result in revocation of the permit. Date Submitted: 7/14/2021 Submitted By: Greta Visser Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #990921 Project Type Activity Type Scope of Work Single Family Residential Alteration Plumbing Project Details Fixtures Clothes Washer 1 Dishwasher 1 Shower, Tub or Combo 1 Water Heater - Gas Mechanical 1 Sinks Sink 1 Other pot filler 1 Work Location Work Description/Location (example: 1 st floor, Kitchen sink, dishwasher and pot filler above stove. Master Bath, Garage) Bathroom tub -shower combo. Laundry room laundry box and gas water heater. Page 2 of 2