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BLD2023-0724_Application_6.9.2023_12.58.56_PM_3600133CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1330701 -Nice Residence Applicant First Name Last Name Company Name Robin Kearsley Kearsley Homes Number Street Apartment or Suite Number E-mail Address 6631 Norma Beach Road r@kearsleyhomes.com City State Zip Phone Number Extension Edmonds WA 98026 (425) 478-6380 Contractor Company Name KEARSLEY HOMES INC Number Street Apartment or Suite Number 6631 Norma Beach Road City State Zip Phone Number Extension Edmonds WA 98026 (425) 478-6380 State License Number License Expiration Date UBI # E-mail Address KEARSHI005NH 10/23/2023 F;ngng iF;g r@kearsleyhomes.com Project Location Number Street Floor Number Suite or Room Number 848 PUGET WAY City Zip Code County Parcel Number EDMONDS 98020 00496000001100 Associated Building Permit Number Tenant Name BLD2022-1227 Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Ryan & Tiffany Nice Number Street Apartment or Suite Number 848 PUGET 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: 6/9/2023 Submitted By: Robin Kearsley Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1330701 -Nice Residence Project Contact Company Name: Kearsley Homes Name: Robin Kearsley Email: r@kearsleyhomes.com Address: 6631 Norma Beach Road Phone #: (425) 478-6380 Edmonds WA 98026 Project Type Activity Type Scope of Work Single Family Residential New Plumbing Project Name: Nice Residence Description of Work: Complete plumbing rough in for new single family remodel work Project Details Scope of Work Plumbing Fixtures for Building Permit Drains Floor Drain Fixtures Clothes Washer Dishwasher Hose Bib Instant Hot water Tap Pressure Reducing Valve - Plum Shower, Tub or Combo Toilet Water Heater - Tankless Sinks Sink Piping Back Flow Preventer Piping - Water Service Water Supply Piping Backflow Protective Device - 2" or smaller 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 3 1 1 4 4 1 5 1 1 1 Complete house remodel. Lower & upper floor and garage Page 2 of 2