BLD2022-0240+Application+2.23.2022_2.29.54_PM+2698720 (2)CITY OF EDMONDS M BtaildingPermit.com
Plumbing Application #1097174 - SMC EDMONDS ENDOSCOPY MEDIVATOR ADD
Applicant
First Name Last Name
Company Name
AMANDA MOORE
MacDonald Miller Facility Solutions
Number Street
Apartment or Suite Number E-mail Address
7717 Detroit Ave SW
permits(�D_macmiller.com
City State Zip
Phone Number Extension
Seattle WA 98106
2068674133
Contractor
Company Name
MACDONALD MILLER FAC SOL INC
Number Street
Apartment or Suite Number
7717 Detroit Ave SW
City State Zip
Phone Number Extension
Seattle WA 98106
2068674133
State License Number License Expiration Date
UBI # E-mail Address
MACDOFS798P9 10/25/2023
602254260 permits(a_)_macmiller.com
Project Location
Number Street
Floor Number Suite or Room Number
21601 76TH AVE W
1 & 6 NONE
City Zip Code
County Parcel Number
EDMONDS 98026
00580700002500
Associated Building Permit Number
Tenant Name
SWEDISH MEDICAL CENTER EDMONDS
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
First Name Last Name or Company Name
PUBLIC HOSPITAL DISTRICT 2 SNOHOMISH CO
Number Street Apartment or Suite Number
4710 196TH ST SW
City State Zip
LYNNWOOD WA 98036-5517
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: 2/23/2022 Submitted By: AMANDA MOORE
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CITY OF EDMONDS MYBuildingPerrnit.com
Plumbing Application #1097174 - SMC EDMONDS ENDOSCOPY MEDIVATOR ADD
Project Contact
Company Name: MacDonald Miller Facility
Solutions
Name: AMANDA MOORE Email: permits@macmiller.com
Address: 7717 Detroit Ave SW Phone #: 2068674133
Seattle WA 98106
Project Type
Nonresidential
Activity Type
Alteration
Scope of Work
Plumbing
Project Name: SMC EDMONDS ENDOSCOPY MEDIVATOR ADD
Description of Work: Temporary water line on Level 1 for an Endoscopy Medivator and the installation of the
plumbing piping for (1) Medivator on level 6.
Project Details
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
Work Description/Location (example: 1st floor, 1ST AND 6TH FLOOR
Master Bath, Garage)
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