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BLD2023-0855_Application_7.11.2023_9.14.45_AM_3657812CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1344984 - Water heater replacements Applicant First Name Last Name Company Name Van Brink Building Integrity Number Street Apartment or Suite Number E-mail Address 3414 buildingintegrity@outlook.com City State Zip Phone Number Extension Bellevue WA 98009 (425) 269-0590 Contractor Company Name BUILDING INTEGRITY LLC Number Street Apartment or Suite Number PO Box 3414 City State Zip Phone Number Extension BELLEVUE WA 98009 (425) 269-0590 State License Number License Expiration Date UBI # E-mail Address BUILDIL902JW 5/5/2024 FD:3DD1 sis buildingintegrity@outlook.com Project Location Number Street Floor Number Suite or Room Number 23220 EDMONDS WAY 23226 Edmonds 105 City Zip Code County Parcel Number EDMONDS 98026 00555300100902 Associated Building Permit Number Tenant Name 1343536 JASON, ANDREA COOLEY Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name KAUTZ ROUTE LLC Number Street Apartment or Suite Number PO BOX 31097 City State Zip SEATTLE WA 98103 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: 7/11/2023 Submitted By: Van Brink Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1344984 - Water heater replacements Project Contact Company Name: Building Integrity Name: Van Brink Email: buildingintegrity@outlook.com Address: 3414 Phone #: (425) 269-0590 Bellevue WA 98009 Project Type Multifamily Residential Activity Type Repair or Replacement Project Name: Water heater replacements Description of Work: changing out water heater in garage Project Details Scope of Work Plumbing Fixtures for Building Permit Plumbing Fixtures Per Plans Additional Project Information Total number of fixtures being added or altered 1 Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) garage Work to be performed by a licensed contractor Yes Scope of Work Plumbing Page 2 of 2