BLD2022-1219_Application_9.14.2022_10.38.01_AM_3107711CITY OF EDMONDS M BuildingPermit.com
Plumbing Application #1201731 - Roberson Addition
Applicant
First Name Last Name Company Name
Shauna Roberson
Number Street Apartment or Suite Number E-mail Address
7622 175th ST SW mail.shauna@gmail.com
City State Zip Phone Number Extension
Edmonds WA 98026 (206) 235-4460
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
7622 175TH ST SW
City Zip Code County Parcel Number
EDMONDS 98026 27040700404100
Associated Building Permit Number Tenant Name
BId2022-0066
Additional Information (i.e. equipment location or special instructions)_
Work Location
Property Owner
First Name Last Name or Company Name
Shauna Roberson
Number Street Apartment or Suite Number
7622 175TH ST SW
City State Zip
EDMONDS WA 98026
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: 9/14/2022 Submitted By: Shauna Roberson
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CITY OF EDMONDS MyBuildingPermit.com
Plumbing Application #1201731 - Roberson Addition
Project Contact
Company Name:
Name:
Address:
Shauna Roberson
7622 175th ST SW
Edmonds WA 98026
Project Type
Single Family Residential
Email: mail.shauna@gmail.com
Phone #: (206) 235-4460
Activity Type Scope of Work
New Plumbing
Project Name: Roberson Addition
Description of Work: Addiing addition with powder room, bathroom, bedroom, and future kitchenette
Project Details
Scope of Work
Plumbing Fixtures for Building Permit
Fixtures
Dishwasher
1
Hose Bib
2
Shower, Tub or Combo
1
Toilet
2
Sinks
Sink
3
Piping
Back Flow Preventer
1
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,
Permitted addition
Master Bath, Garage)
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