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BLD2021-1308_Application_9.23.2021_11.43.57_AM_2425222CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1024354 - Taco Bell Applicant First Name Last Name Company Name MIKE MADDEN MADDEN MECHANICAL Number Street Apartment or Suite Number E-mail Address 22003 106th St. E. MADMIKN@MSN.COM City State Zip Phone Number Extension BUCKLEY WA 98321 (253)569-0188 Contractor Company Name MADDEN MECHANICAL INC Number Street Apartment or Suite Number 22003 106TH ST E City State Zip Phone Number Extension BUCKLEY WA 98321 (253)569-0188 State License Number License Expiration Date UBI # E-mail Address MADDEMIOOOJJ 4/15/2023 Fn9n95g64 MADMIKN@MSN.COM Project Location Number Street Floor Number Suite or Room Number 10119 EDMONDS WAY 1 none City Zip Code County Parcel Number EDMONDS 98020 00610600300700 Associated Building Permit Number Tenant Name Taco Bell Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name *Mike Madden 9323 LLC Number Street Apartment or Suite Number 111 W 39TH ST City State Zip VANCOUVER WA 98660 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: 9/23/2021 Submitted By: MIKE MADDEN Page 1 of 2 i CITY OF EDMONDS MyBuitdingPermit.com Plumbing Application #1024354 - Taco Bell Project Contact Company Name: MADDEN MECHANICAL Name: MIKE MADDEN Email: MADMIKN@MSN.COM Address: 22003 106th St. E. Phone #: (253)569-0188 BUCKLEY WA 98321 Project Type Nonresidential Activity Type Repair or Replacement Project Name: Taco Bell Description of Work: Replace Like for Like Water Heater Project Details Scope of Work Like for like equipment in the same location Type of Use Work includes commercial kitchen, food svc, med gas, lab, medical use, or dental use. 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 1 Work Location Work Description/Location (example: 1st floor, Janitors closet Master Bath, Garage) Scope of Work Plumbing Page 2 of 2