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Application_1012540CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1012540 Applicant First Name Last Name Patrick Dickinson Company Name Service Plumbing and Heating Inc Number Street 2100 196th St SW Apartment or Suite Number E-mail Address info@serviceph.net City State Zip Lynnwood WA 98036 Phone Number Extension 4256402121 Contractor Company Name SERVICE PLUMBING & HEATING INC Number Street 2100 196th St SW Apartment or Suite Number City State Zip Lynnwood WA 98036 Phone Number Extension (425) 640-2121 State License Number License Expiration Date SERVIPH953QD 11/11/2021 UBI # E-mail Address FD99.1R671 info@serviceph.net Project Location Number Street 1615 9TH AVE N Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 27031300406300 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 William L\ Mary T Akers Number Street 1615 9TH AVE N 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: 8/30/2021 Submitted By: Patrick Dickinson Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1012540 Project Type Activity Type Scope of Work Single Family Residential Repair or Replacement Plumbing Project Details Fixtures Dishwasher 1 Hose Bib 3 Shower, Tub or Combo 4 Toilet 4 Hot Water Heater 1 Sinks Sink 8 Other 2 -Sump Pumps - 1 DCVA 3 Work Location Work Description/Location (example: 1st floor, Rough in ,Bathroom , Utility Room , Kitchen, Laundry Master Bath, Garage) Room, Guest Bath & Powder room, sump pumps & DCVA Page 2 of 2