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BLD2021-1570_Application_11.17.2021_4.11.10_PM_2525990CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1051613 - Hot Water Heater Applicant First Name Last Name Company Name Jimmie Williams Specialty Insulation Number Street Apartment or Suite Number E-mail Address 218 Main St Suite 479 pamela@specialtyinsulation.com City State Zip Phone Number Extension Kirkland WA 98033 4258984390 Contractor Company Name SPECIALTY INSULATION NW LLC Number Street Apartment or Suite Number 218 Main St Suite 479 City State Zip Phone Number Extension Kirkland WA 98033 4258984390 State License Number License Expiration Date UBI # E-mail Address PLATICP822DG 3/7/2022 BD:31451 97 pamela@specialtyinsulation.com Project Location Number Street Floor Number Suite or Room Number 7220 208TH ST SW 2 City Zip Code County Parcel Number EDMONDS 98026 00858122000200 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 Joseph K Vail Number Street Apartment or Suite Number 2266 WHIDBEY SHORES RD City State Zip LANGLEY WA 98260 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: 11/17/2021 Submitted By: Jimmie Williams Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1051613 - Hot Water Heater Project Contact Company Name: Specialty Insulation Name: Jimmie Williams Email: pamela@specialtyinsulation.com Address: 218 Main St Suite 479 Phone #: 4258984390 Kirkland WA 98033 Project Type Activity Type Scope of Work Single Family Condominium Unit Repair or Replacement Plumbing Project Name: Hot Water Heater Description of Work: Replace Gas Hot Water Heater 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: 1 st floor, 1 st floor Master Bath, Garage) Page 2 of 2