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BLD2022-1580_Application_11.15.2022_5.59.42_PM_3222074CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1230421 - Collins Addition Applicant First Name Last Name Company Name Anthony Collins Number Street Apartment or Suite Number E-mail Address 21821 80 Ave W acollins3@frontier.com City State Zip Phone Number Extension Edmonds WA 98026 (206) 437-2277 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 21821 80TH AVE W City Zip Code County Parcel Number EDMONDS 98026 00461000201002 Associated Building Permit Number Tenant Name bld2022-0797 Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Anthony James & Amy Margrethe Collins Number Street Apartment or Suite Number 21821 80th Ave W 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: 11/15/2022 Submitted By: Anthony Collins Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1230421 - Collins Addition Project Contact Company Name: Name: Address: Anthony Collins 21821 80 Ave W Edmonds WA 98026 Project Type Single Family Residential Email: acollins3@frontier.com Phone #: (206) 437-2277 Activity Type Scope of Work New Plumbing Project Name: Collins Addition Description of Additional space added to single family home to include a new master bathroom and Work: bedroom, moving the kitchen into the new space, and remodelling the laundry room from unheated garage space to interior space. HWH gets moved and upgraded in the house also. Project Details Scope of Work Plumbing Fixtures for Building Permit Fixtures Clothes Washer Dishwasher Hose Bib Ice Maker Shower, Tub or Combo Toilet Hot Water Heater Sinks Sink 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, Master Bath, Garage) 1 1 1 1 1 1 1 4 rear of existing house -- inside the addition area to the home. all single floor and crawlspace work Page 2 of 2