BLD2022-0505_Application_4.21.2022_4.46.19_PM_2820201CITY OF EDMONDS M BuildingPermit.com
Plumbing Application #1129687 - 859 PUGET
Applicant
First Name Last Name Company Name
KATHY BUTTERLY SUPREME PLUMBING COMPANY LLC
Number Street Apartment or Suite Number E-mail Address
PO Box 2054 supremeplumbingco@hotmail.com
City State Zip Phone Number Extension
Kingston WA 98346 2062616282
Contractor
Company Name
SUPREME PLUMBING COMPANY LLC
Number Street Apartment or Suite Number
PO Box 2054
City State Zip Phone Number Extension
Kingston WA 98346 (206) 261-6282
State License Number License Expiration Date UBI # E-mail Address
SUPREPC783BJ 1/11/2024 Rn19g4B4.,i supremeplumbingco@hotmail.com
Project Location
Number Street Floor Number Suite or Room Number
859 PUGET WAY
City Zip Code County Parcel Number
EDMONDS 98020 00496000000100
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
Kristi M Larsen
Number Street Apartment or Suite Number
859 PUGET WAY
City State Zip
EMONDS 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: 4/21/2022 Submitted By: KATHY BUTTERLY
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CITY OF EDMONDS MyBuildingPermit.com
Plumbing Application #1129687 - 859 PUGET
Project Contact
Company Name: SUPREME PLUMBING
COMPANY LLC
Name: KATHY BUTTERLY Email: supremeplumbingco@hotmail.com
Address: PO Box 2054 Phone #: 2062616282
Kingston WA 98346
Project Type
Single Family Residential
Activity Type
Alteration
Scope of Work
Plumbing
Project Name: 859 PUGET
Rough -in: Tie into 3" sewer line, h/c waterlines in crawl space of main structure. Run lines to
Description of new bathroom addition picking up 1 water closet, 1 shower and 2 lavatories. Hang shower
Work: valve w/ diverter and install hand held and shower head. Trim: Trim out 1 water closet, 1
shower valve w/diverter for hand held and shower head, double lavatory.
Project Details
Scope of Work
Plumbing Fixtures for Building Permit
Fixtures
Shower, Tub or Combo 1
Toilet 1
Sinks
Sink 2
Associated Building Permit?
There is or will be a building permit associated with
this work at the project location.
Work Location
Work Description/Location (example: 1st floor, Main floor
Master Bath, Garage)
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