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BLD2020-0751+Application+7.21.2020_3.56.33_PMCITY OF EDMONDS Plumbing Application #819862 - Graphite Arts Applicant First Name Last Name Carol Reilmann Number Street Apartment or Suite Number 11875 Silverdale Way City State Zip Silverdale WA 98383 Contractor Company Name SILVERDALE PLUMBING/HEATNG INC Number Street 11875 Silverdale Way NW City State Zip Silverdale WA 98383 State License Number License Expiration Date SILVEI*220NU 8/31/2020 Project Location Number Street 202 MAIN ST City Zip Code EDMONDS 98020 Associated Building Permit Number BLD2019-1111 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Mary Number Street 221 2ND AVE N City EDMONDS MyBuildingPermit.com Company Name Silverdale Plumbing & Heatinq, Inc. E-mail Address carol (a_silverdaleplumbinq.com Phone Number Extension (360)692-8840 18 Apartment or Suite Number Suite 104 Phone Number Extension (360) 692-8840 UBI # E-mail Address 600322296 carol(a)_silverdaleplumbinq.com County Parcel Number 00454800101300 Tenant Name Graphite Arts I Last Name or Company Name Olson State Zip WA 98020-3103 Certification Statement - The applicant states: Floor Number Suite or Room Number 1 None Apartment or Suite Number 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: 7/21/2020 Submitted By: Carol Reilmann Page 1 of 2 CITY OF EDMONDS Mysu;laingPerrnit.com Plumbing Application #819862 - Graphite Arts Project Contact Company Name: Silverdale Plumbing & Heating, Inc. Name: Dennis Dlugosh Email: dennis@silverdaleplumbing.com Address: 11875 Silverdale Way Phone #: (360)692-8840 23 Silverdale WA 98383 Project Type Activity Type Scope of Work Nonresidential New Plumbing Project Name: Graphite Arts I Description of Work: Underground plumbing only: underground, sanitary, storm & water supply within 5' of outside of building. Project Details Type of Use Work does NOT have med gas, commercial kitchen, food svc, lab, medical, 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 42 Work Location Work Description/Location (example: 1 st floor, 1st Floor. Master Bath, Garage) Page 2 of 2