BLD2021-1533_Application_11.10.2021_11.04.22_AM_2513125CITY OF EDMONDS M BuildingPermit.com
Plumbing Application #1047867 - Water Heater
Applicant
First Name Last Name Company Name
Xiaomei Xu
Number Street Apartment or Suite Number E-mail Address
PO Box 116 clearlakeintl@gmail.com
City State Zip Phone Number Extension
Edmonds WA 98020 6784679922
Contractor
Company Name
PROTOCOL PLUMBING & SEWER
Number Street Apartment or Suite Number
917 110th pl. se
City State Zip Phone Number Extension
everett WA 98208 (425) 743-4940
State License Number License Expiration Date UBI # E-mail Address
PROTOPS794PG 10/5/2023 ,;n9F;7nns.,i clearlakeintl@gmail.com
Project Location
Number Street Floor Number Suite or Room Number
510 FORSYTHE LN 307
City Zip Code County Parcel Number
EDMONDS 98020 00762400030700
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
Xu Xiaomei
Number Street Apartment or Suite Number
PO BOX 116
City State Zip
EDMONDS WA 98020
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: 11/10/2021 Submitted By: Xiaomei Xu
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CITY OF EDMONDS MyBuitdingPermit.com
Plumbing Application #1047867 - Water Heater
Project Contact
Company Name:
Name:
Address:
Xiaomei Xu
PO Box 116
Edmonds WA 98020
Project Type
Single Family Condominium Unit
Email: clearlakeintl@gmail.com
Phone #: 6784679922
Activity Type Scope of Work
Repair or Replacement Plumbing
Project Name: Water Heater
Description of Work: Replace existing electric water heater by equivalent model.
Project Details
Scope of Work
Like for like equipment in the same location
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, 3rd floor, washer/drier room
Master Bath, Garage)
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