BLD2021-1257_Application_9.9.2021_4.23.15_PM_2400922CITY OF EDMONDS M BuildingPermit.com
Plumbing Application #1017654 - Install water heater
Applicant
First Name Last Name Company Name
Kathleen R Ker3wat
Number Street Apartment or Suite Number E-mail Address
20632 76th Avenue West 14 Krkwatt@aol.com
City State Zip Phone Number Extension
Edmonds WA 98026-6813 4257757555
Contractor
Company Name
BENLA WATER HEATERS INC
Number Street Apartment or Suite Number
930 Industrial Dr
City State Zip Phone Number Extension
Tinter City WA 98188 425339-9494
State License Number License Expiration Date UBI # E-mail Address
BENLAWH822BD 1 /4/2022 FD417q 17q Jenny@benla.812
Project Location
Number Street Floor Number Suite or Room Number
20632 76TH AVE W 14
City Zip Code County Parcel Number
EDMONDS 98026 00784600001400
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
Kathleen R Kerwat
Number Street Apartment or Suite Number
20632 76TH AVE W 14
City State Zip
EDMONDS WA 98026-6813
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: 9/9/2021 Submitted By: Kathleen R Ker3wat
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CITY OF EDMONDS MyBuitdingPermit.com
Plumbing Application #1017654 - Install water heater
Project Contact
Company Name:
Name: Kathleen R Ker3wat Email: Krkwatt@aol.com
Address: 20632 76th Avenue West 14 Phone #: 4257757555
Edmonds WA 98026-6813
Project Type Activity Type
Single Family Condominium Unit Repair or Replacement
Project Name: Install water heater
Description of Work: Install a 40 gallon gas water heater in same area
Project Details
Scope of Work
Like for like equipment in the same location
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
Second floor bedroom closet
Scope of Work
Plumbing
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