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BLD2022-1598_Application_11.18.2022_2.50.12_PM_3229041CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1231336 - Zevenbergen Capital Applicant First Name Last Name Company Name Kelsey King AMERICAN MECHANICAL CORPORATION Number Street Apartment or Suite Number E-mail Address 15820 Ambaum Blvd SW kelsey@americanmechanicalcorp.com City State Zip Phone Number Extension Burien WA 98166 (206) 467-6407 Contractor Company Name AMERICAN MECHANICAL CORP Number Street Apartment or Suite Number 15820 Ambaum Blvd SW City State Zip Phone Number Extension BURIEN WA 98166 2064676407 State License Number License Expiration Date UBI # E-mail Address AMERIMC796MG 7/12/2023 RB14iisi R kelsey@americanmechanicalcorp.com Project Location Number Street Floor Number Suite or Room Number 326 ADMIRAL WAY 2 None City Zip Code County Parcel Number EDMONDS 98020 27032300401400 Associated Building Permit Number Tenant Name Zevenbergen Capital Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name EDMONDS PORT OF Number Street Apartment or Suite Number 300 ADM I RAIL WAY City State Zip EDMONDS WA 98020 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: 11/18/2022 Submitted By: Kelsey King Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1231336 - Zevenbergen Capital Project Contact Company AMERICAN MECHANICAL Name: CORPORATION Name: Kelsey King Email: kelsey@americanmechanicalcorp.com Address: 15820 Ambaum Blvd SW Phone #: (206) 467-6407 Burien WA 98166 Project Type Activity Type Scope of Work Nonresidential Alteration Plumbing Project Name: Zevenbergen Capital Description of Rough-in/Install breakroom fixtures including (1) sink/faucet, (2) dishwashers, and (1) 1/2" Work: RPBA for sparkling water faucet/dispenser. Hot water to be tied into existing hot water source. Project Details Scope of Work Plumbing Fixtures for Building Permit Type of Use Work does NOT have med gas, commercial kitchen, food svc, lab, medical, or dental use. Associated Building Permit? There is or will be a building permit associated with this work at the project location. Additional Project Information Total number of fixtures being added or altered Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) 4 2nd Floor Breakroom Page 2 of 2