BLD2022-1682_Application_12.12.2022_1.51.50_PM_3264428CITY OF EDMONDS M BuildingPermit.com
Plumbing Application #1241481 - Temp Office Waterline
Applicant
First Name Last Name Company Name
Lauren Golembiewski Glacier Environmental Services, Inc.
Number Street Apartment or Suite Number E-mail Address
PO Box 1097 LMiles@glacierenviro.com
City State Zip Phone Number Extension
Mukilteo WA 98275 (425) 355-2826
Contractor
Company Name
GLACIER ENVIRONMENTAL SRVC INC
Number Street Apartment or Suite Number
PO Box 1097
City State Zip Phone Number Extension
Mukilteo WA 98275 425-355-2826
State License Number License Expiration Date UBI # E-mail Address
GLACIES108C7 1/14/2024 FD1 995417 LMiles@glacierenviro.com
Project Location
Number Street Floor Number Suite or Room Number
7509 212TH ST SW 1 none
City Zip Code County Parcel Number
EDMONDS 98026 00566900400600
Associated Building Permit Number Tenant Name
BLD2022-0982 Glacier Environmental Services, Inc
Additional Information (i.e. equipment location or special instructions)_
Work Location
Property Owner
First Name Last Name or Company Name
DRT HOLDINGS
Number Street Apartment or Suite Number
LLC
City State Zip
MUKILTEO WA 98275
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: 12/12/2022 Submitted By: Lauren Golembiewski
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CITY OF EDMONDS MyBuildingPermit.com
Plumbing Application #1241481 - Temp Office Waterline
Project Contact
Company Name: Glacier Environmental Services,
Inc.
Name: Lauren Golembiewski Email: LMiles@glacierenviro.com
Address: PO Box 1097 Phone #: (425) 355-2826
Mukilteo WA 98275
Project Type
Nonresidential
Activity Type
Repair or Replacement
Project Name: Temp Office Waterline
Description of Work: 3/4" water service line for temporary trailer
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.
Work Location
Work Description/Location (example: 1st floor,
Master Bath, Garage)
Scope of Work
Plumbing
Water service line to temporary trailer, underground
work only
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