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Application_2021-1278CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1019554 Applicant First Name Alexander Last Name Company Name Visser Prima Plumbing Number Street 903 NW 50th St Apartment or Suite Number E-mail Address staff@primaplumbingnw.com City State Seattle WA Zip Phone Number Extension 98107 2067060300 Contractor Company Name Prima Plumbing Number Street 903 NW 50th St Apartment or Suite Number City Seattle State Zip Phone Number Extension WA 98107 (206) 706-0300 State License Number PRIMAP*004J4 License Expiration Date UBI # E-mail Address 4/18/2023 RDgD9g97R staff@primaplumbingnw.com Project Location Number Street 22050 99TH PL W Floor Number Suite or Room Number City EDMONDS Zip Code County Parcel Number 98020 00602100100700 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Matt and Bethany Last Name or Company Name Hart and Childress Number Street 22050 99th PI W Apartment or Suite Number City Edmonds State Zip WA 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: 9/14/2021 Submitted By: Alexander Visser Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1019554 Project Type Single Family Residential Project Details Activity Type Repair or Replacement Fixtures Shower, Tub or Combo Toilet Sinks Sink Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) 2 1 2 Scope of Work Plumbing Master Bathroom Remodel - 1 toilet, 2 lav sinks, 1 soaker tub and 1 shower. Page 2 of 2