Application_1216236CITY OF EDMONDS M BuildingPermit.com
Plumbing Application #1216236
Applicant
First Name Last Name
McKena Anderson
Company Name
Pacific Bath Company
Number Street
17880 NE Airport Way
Apartment or Suite Number E-mail Address
110 permits@speconnw.com
City State Zip
portland OR 97230
Phone Number Extension
(206) 565-2035
Contractor
Company Name
PACIFIC BATH COMPANY
Number Street
6521 SE CROSSWHITE WAY
Apartment or Suite Number
A
City State Zip
PORTLAND WA 97206
Phone Number Extension
(206)565-2030 (206)565-2030
State License Number License Expiration Date
SPECICN793OZ 8/31/2023
UBI # E-mail Address
FD357F144 permits@speconnw.com
Project Location
Number Street
23927 104TH AVE W
Floor Number Suite or Room Number
City Zip Code
EDMONDS 98020
County Parcel Number
00555100000904
Associated Building Permit Number
S18576
Tenant Name
Additional Information (i.e. equipment location or special instructions)_
Work Location
Property Owner
First Name Last Name or Company Name
Paulette Hauck
Number Street
23927 104TH AVE W
Apartment or Suite Number
City State
EDMONDS WA
Zip
98026
Certification Statement - The applicant states:
I certify that I am the owner of this property or the owner's authorized agent, including an appropriately licensed contractor. I have furnished true and
correct information. I will comply with all provisions of law and ordinances governing this type of construction work, whether specific herein or not. By
submitting this application I give the jurisdiction permission to enter the property to perform inspections. I understand that failure to comply with the above
may result in revocation of the permit.
Date Submitted: 10/14/2022 Submitted By: McKena Anderson
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CITY OF EDMONDS MyBuildingPermit.com
Plumbing Application #1216236
Project Type
Single Family Residential
Project Details
Drains
Floor Drain
Activity Type
Repair or Replacement
1
Fixtures
Shower, Tub or Combo 1
Associated Building Permit?
There is no other onsite work that requires a building
permit.
Work Location
Work Description/Location (example: 1st floor, bathroom
Master Bath, Garage)
Scope of Work
Plumbing
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