Application_2021-1447CITY OF EDMONDS M BuildingPermit.com
Plumbing Application #1038299
Applicant
First Name Last Name Company Name
Dan Des Laurier
Number Street Apartment or Suite Number E-mail Address
7859 S 180th ddeslaurier@pacificbath.com
City State Zip Phone Number Extension
Kent WA 98032 2065652046
Contractor
Company Name
PACIFIC BATH COMPANY
Number Street Apartment or Suite Number
17880 NE Airport Way #110
City State Zip Phone Number Extension
PORTLAND WA 97230 (206)565-2046 (206)565-2030
State License Number License Expiration Date UBI # E-mail Address
SPECICN793OZ 8/31/2023 BD.157B144 ddeslaurier@pacificbath.com
Project Location
Number Street Floor Number Suite or Room Number
19715 80TH PL W
City Zip Code County Parcel Number
EDMONDS 98026 00506400001200
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
T P Albertson
Number Street Apartment or Suite Number
19715 80TH PL W
City State Zip
EDMONDS WA 98026-6405
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: 10/21/2021 Submitted By: Dan Des Laurier
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CITY OF EDMONDS MyBuildingPermit.com
Plumbing Application #1038299
Project Type
Single Family Residential
Project Details
Fixtures
Shower, Tub or Combo
Work Location
Activity Type
Repair or Replacement
Work Description/Location (example: 1st floor, Bathroom
Master Bath, Garage)
Scope of Work
Plumbing
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