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BLD2021-0502+Application+4.8.2021_8.51.05_AM+2134299CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #946592 - Distinctive Dentistry Applicant First Name Last Name Company Name Mike Satko Local Plumbinq And Conctruction Inc. Number Street Apartment or Suite Number E-mail Address 1496 City State Zip Maple Valley WA 98038 Contractor Company Name LOCAL PLUMBING & CONST INC Number Street 1496 City Maple Valley State License Number LOCALPC063J9 Project Location State Zip WA 98038 License Expiration Date 8/23/2021 Number Street 22815 EDMONDS WAY City Zip Code EDMONDS 98020 Associated Building Permit Number Additional Information (i.e. equipment location or special instructions). Work Location Property Owner mikesatko(@_outlook.com Phone Number Extension (425) 432-6647 Apartment or Suite Number Phone Number Extension (425) 432-6647 UBI # E-mail Address 601491379 mikesatko(cb_outlook.com County Parcel Number 27033600102700 Tenant Name Dr. Zach Streit Floor Number Suite or Room Number 1 None First Name Last Name or Company Name * DERKSEN LLC* Number Street Apartment or Suite Number 19827 15TH AVE NW City State Zip SHORELINE WA 98177 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: 4/8/2021 Submitted By: Mike Satko Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #946592 - Distinctive Dentistry Project Contact Company Name: Local Plumbing And Conctruction Inc. Name: Mike Satko Email: mikesatko@outlook.com Address: 1496 Phone #: (425) 432-6647 Maple Valley WA 98038 Project Type Nonresidential Activity Type Alteration Scope of Work Plumbing Project Name: Distinctive Dentistry Description of Work: Plumbing installation for Dental practice Project Details Type of Use Work includes commercial kitchen, food svc, med gas, lab, medical use, or dental use. Associated Building Permit? There is or will be a building permit associated with this work at the project location. Additional Project Information Total number of fixtures being added or altered Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) 10 Plumbing for Dental office TI Page 2 of 2