Permit_1216236CITY OF EDMONDS
Plumbing Permit
My6uildingPermitxom
Permit Information
Permit Number
RI n9n97-1 Am Issued Date
10/14/2022
Expiration Date
4/12/2023
Job Address
23927 104TH AVE W Fee Paid
$120.00
EDMONDS, 98020 Order Confirmation
1179634
Floor
Related Permit #
S 18576
Suite
Application ID
1216236
Contact Information
Contact Name
Jim Riedstra Contractor
PACIFIC BATH COMPANY
Phone Number
(206)565-2030EXt (206)565-2030
Property Owner
Paulette Hauck LNI License#
SPECICN793OZ
Address
23927 104TH AVE W EDMONDS, Phone#
(206)565-2030
WA City Bus. License #
verified
Property Owner Phone
(206) 930-4006 Tenant Name
Job Description
A (Single Family Residential) (Repair or Replacement) Plumbing project involving ( 1 Floor Drain, 1 Shower, Tub or
Combo, There is no other onsite work that requires a building permit.)
bathroom
Conditions - Post Permit on site. Do not cover until inspected.
Plumbing contractor license laws are regulated by Chapter 18.106 RCW. Property owners who hire an
unlicensed plumber may assume the risks and potential monetary liability for work performed by unlicensed
plumbing contractors. For more information contact L&I Department of Licensing at 1-800-647-0982.
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.
Applicant: McKena Anderson
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1893
CITY OF EDMONDS
Plumbing Permit
My6uildingPermitxom
Permit Information
Permit Number
RI n9n99_1AnF
Issued Date
10/14/2022
Expiration Date
4/12/2023
Job Address
23927 104TH AVE W
Fee Paid
$120.00
EDMONDS, 98020
Order Confirmation
1179634
Floor
Related Permit #
S 18576
Suite
Application ID
1216236
Inspections
Inspection IVR Inspector Date Inspection
IVR Inspector Date
Rough In Plumbing
Plumbing Final
Inspection Scheduling
The issuance of this permit in no way constitutes approval from any other agencies having regulatory authority over
the facility and this construction activity. It is the responsibility of the property owner
to obtain any and all such
required approvals.
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