BLD2021-1472+Application+10.27.2021_7.36.34_AM+2485196CITY OF EDMONDS MyBuildingPermit.com
Plumbing Application #1040893 - Plumbing back flow preventers
Applicant
First Name
Last Name Company Name
Timothy
Peacock Niles Peacock Kitchen & Bar
Number Street
Apartment or Suite Number E-mail Address
178 Sunset Ave S
niles(a_nilespeacock.com
City State
Zip Phone Number Extension
Edmonds WA
98020 3056105425
Contractor
Company Name
MX PLUMBING INC
Number Street
Apartment or Suite Number
1430 W. Casino Rd
43
City
State Zip Phone Number Extension
Everett
WA 98204 (206) 818-1187
State License Number
License Expiration Date UBI # E-mail Address
MXPLUP19031_8
6/28/2022 603023847 niles(cD_nilespeacock.com
Project Location
Number Street
Floor Number Suite or Room Number
178 SUNSET AVE
S 1 178
City
Zip Code County Parcel Number
EDMONDS
98020 27032300104500
Associated Building Permit Number
Tenant Name
Niles Peacock Kitchen & Bar
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
First Name Last Name or Company Name
Wayne & Edmonds Retail & Popeyes Fort
Number Street Apartment or Suite Number
940 EMMET AVE.
City State Zip
BELMONT CA 94002
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: 10/27/2021 Submitted By: Timothy Peacock
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CITY OF EDMONDS Mysu;laingPerrnit.com
Plumbing Application #1040893 - Plumbing back flow preventers
Project Contact
Company Name: Niles Peacock Kitchen & Bar
Name: Timothy Peacock Email: niles@nilespeacock.com
Address: 178 Sunset Ave S Phone #: 3056105425
Edmonds WA 98020
Project Type
Nonresidential
Activity Type
Repair or Replacement
Project Name: Plumbing back flow preventers
Description of Work: Updating 4 Backflow preventers
Project Details
Scope of Work
Like for like equipment in the same location
Type of Use
Work includes commercial kitchen, food svc, med
gas, lab, medical use, or dental use.
Associated Building Permit?
There is no other onsite work that requires a building
permit.
Additional Project Information
Total number of fixtures being added or altered 4
Work Location
Scope of Work
Plumbing
Work Description/Location (example: 1 st floor, Updated back flow preventers for kitchen dishwasher
Master Bath, Garage) and ice machine, and for bar dishwasher and soda
fountain per building department requirements.
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