BLD2021-1680+Application+12.13.2021_3.22.55_PM+2569284CITY OF EDMONDS MyBuildingPermit.com
Plumbing Application #1063471 - Skin and laser
Applicant
First Name Last Name Company Name
Daniel De alba NIRVANA MECHANICAL LLC
Number Street Apartment or Suite Number E-mail Address
13310 Seattle hill Rd B dealba(cD_nirvanamechanical.com
City State Zip Phone Number Extension
Mill Creek WA 98012 2064763304
Contractor
Company Name
NIRVANA MECHANICAL LLC
Number Street
Apartment or Suite Number
10922 NE 34thpl
1
City
State Zip
Phone Number Extension
BELLEVUE
WA 98004
(206) 476-3304
State License Number
License Expiration Date
UBI #
E-mail Address
NIRVAML845R8
12/28/2022
604065597
deal ba(a)_nirvanamechanical.com
Project Location
Number Street
Floor Number Suite or Room Number
21727 76TH AVE W
2nd floor Suite F
City
Zip Code
County Parcel Number
EDMONDS
98026
00580700002701
Associated Building Permit Number
Tenant Name
BLD2021-1456
Skin and laser
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
First Name
Number Street
PO BOX 92129
Last Name or Company Name
HR ACQUISITION I CORPORATION
Apartment or Suite Number
City State Zip
SOUTH LAKE TX 76092
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: 12/13/2021 Submitted By: Daniel De alba
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CITY OF EDMONDS Mysu;laingPerrnit.com
Plumbing Application #1063471 - Skin and laser
Project Contact
Company Name: NIRVANA MECHANICAL
LLC
Name: Daniel De alba Email: dealba@nirvanamechanical.com
Address: 13310 Seattle hill Rd B Phone #: 2064763304
Mill Creek WA 98012
Project Type Activity Type Scope of Work
Nonresidential Alteration Plumbing
Project Name: Skin and laser
Description of Work: 7 sinks andition for dermatologist clinic
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 7
Work Location
Work Description/Location (example: 1st floor, 2 ND floor
Master Bath, Garage)
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