BLD2022-0175_Application_2.9.2022_11.28.30_AM_2671063CITY OF EDMONDS M BuildingPermit.com
Plumbing Application #1090105 - hwt
Applicant
First Name Last Name Company Name
Rick Van Dyke
Number Street Apartment or Suite Number E-mail Address
7704 191 St sw rickvandyke@comcast.net
City State Zip Phone Number Extension
Edmonds WA 98026 4252807716
Contractor
Company Name
Owner
Number Street Apartment or Suite Number
City State Zip Phone Number Extension
State License Number License Expiration Date UBI # E-mail Address
Project Location
Number Street Floor Number Suite or Room Number
7704 191 ST ST SW
City Zip Code County Parcel Number
EDMONDS 98026 00418000000400
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
R Vandyke
Number Street Apartment or Suite Number
7704 191 ST ST SW
City State Zip
EDMONDS WA 98026-6033
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: 2/9/2022 Submitted By: Rick Van Dyke
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CITY OF EDMONDS MyBuitdingPermit.com
Plumbing Application #1090105 - hwt
Project Contact
Company Name:
Name:
Address:
Richard Van Dyke
7704 191 st sw
Edmonds WA 98026
Project Type
Single Family Condominium Unit
Email: rickvandyke@comcast.net
Phone #: 4252807716
Project Name: hwt
Description of Work: replace hwt like for like
Project Details
Activity Type Scope of Work
Repair or Replacement Plumbing
Scope of Work
Like for like equipment in the same location
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 1
Work Location
Work Description/Location (example: 1st floor, Bathroom
Master Bath, Garage)
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