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Application_1000897CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1000897 Applicant First Name Last Name KATHY BUTTERLY Company Name SUPREME PLUMBING COMPANY LLC Number Street PO Box 2054 Apartment or Suite Number E-mail Address supremeplumbingco@hotmail.com City State Zip Kingston WA 98346 Phone Number Extension 2062616282 Contractor Company Name SUPREME PLUMBING COMPANY LLC Number Street PO Box 2054 Apartment or Suite Number City State Zip Kingston WA 98346 Phone Number Extension (206) 261-6282 State License Number License Expiration Date SUPREPC873KL 6/12/2023 UBI # E-mail Address F;n19g4B4� supremeplumbingco@hotmail.com Project Location Number Street 18416 OLYMPIC VIEW DR Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00565600200301 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 Mohammed & Sam Siow Fong Alobaidi Number Street 18416 OLYMPIC VIEW DR Apartment or Suite Number City State EDMONDS WA Zip 98020 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: 8/3/2021 Submitted By: KATHY BUTTERLY Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1000897 Project Type Activity Type Scope of Work Single Family Residential Alteration Plumbing Project Details Fixtures Clothes Washer 1 Shower, Tub or Combo 1 Toilet 2 Sinks Sink 2 Work Location Work Description/Location (example: 1st floor, Basement Master Bath, Garage) Page 2 of 2