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BLD2022-1640_Application_11.30.2022_7.55.59_PM_3245612CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1236591 - beth paschal Applicant First Name Last Name Company Name bobby williams word works construction Number Street Apartment or Suite Number E-mail Address 1085 tyler james In bwilliams6907@gmail.com City State Zip Phone Number Extension camano island WA 98282 (360) 672-4086 Contractor Company Name GOLDSTAR PLUMBING LLC Number Street Apartment or Suite Number 17510 Brook Blvd City State Zip Phone Number Extension BOTHELL WA 98012 (425)300-9900 State License Number License Expiration Date UBI # E-mail Address GOLDSPL794CP 2/2/2023 BD45Rf11 qR bwilliams6907@gmail.com Project Location Number Street Floor Number Suite or Room Number 23915 76TH AVE W City Zip Code County Parcel Number EDMONDS 98020 00488800600503 Associated Building Permit Number Tenant Name bld2022-1471 Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Patricia M Booriak Number Street Apartment or Suite Number 23915 76TH 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: 11/30/2022 Submitted By: bobby Williams Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1236591 - beth paschal Project Contact Company Name: word works construction Name: bobby williams Email: bwilliams6907@gmail.com Address: 1085 tylerjames In Phone #: (360) 672-4086 camano island WA 98282 Project Type Activity Type Scope of Work Single Family Residential Alteration Plumbing Project Name: beth paschal Description of Work: bathroom remodel, relocation of main plumbing wall by 12inches Project Details Scope of Work Plumbing Fixtures for Building Permit Fixtures Shower, Tub or Combo 1 Toilet 1 Sinks Sink 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: 1 st floor, master bath Master Bath, Garage) Page 2 of 2