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BLD2023-1120_Application_9.6.2023_9.05.17_AM_3765826CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1372075 - Ainsley Master Bath Remodel Applicant First Name Last Name Company Name Shayli Sutton The Plumbing Physician Number Street Apartment or Suite Number E-mail Address PO Box 2213 plumbphy@aol.com City State Zip Phone Number Extension Lynnwood WA 98036 (425) 771-6200 Contractor Company Name PLUMBING PHYSICIAN, THE Number Street Apartment or Suite Number PO Box 2213 City State Zip Phone Number Extension Lynnwood WA 98036 (425) 771-6200 State License Number License Expiration Date UBI # E-mail Address PLUMBP*792PD 10/1/2025 RD17Df1917 plumbphy@aol.com Project Location Number Street Floor Number Suite or Room Number 7429 N MEADOWDALE RD City Zip Code County Parcel Number EDMONDS 98026 00513103000900 Associated Building Permit Number Tenant Name BLD2023-0940 Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Keith A & Pamela L Ainsley Number Street Apartment or Suite Number 7429 N MEADOWDALE RD City State Zip EDMONDS WA 98026 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: 9/6/2023 Submitted By: Shayli Sutton Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1372075 - Ainsley Master Bath Remodel Project Contact Company Name: The Plumbing Physician Name: Shayli Sutton Email: plumbphy@aol.com Address: PO Box 2213 Phone #: (425) 771-6200 Lynnwood WA 98036 Project Type Activity Type Scope of Work Single Family Residential Alteration Plumbing Project Name: Ainsley Master Bath Remodel Description of Work: Master Bath Remodel Project Details Scope of Work Plumbing Fixtures for Building Permit Fixtures Shower, Tub or Combo 1 Toilet 1 Sinks Sink 2 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: 1 st floor, Master Bath Master Bath, Garage) Page 2 of 2