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Application_1397873CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1397873 Applicant First Name Last Name Nicole Williams Company Name Pacific Bath Company Number Street 17880 NE Airport Way Apartment or Suite Number E-mail Address 110 permits@speconnw.com City State Zip portland OR 97230 Phone Number Extension (971) 264-0145 Contractor Company Name PACIFIC BATH COMPANY Number Street 6521 SE CROSSWHITE WAY Apartment or Suite Number A City State Zip PORTLAND WA 97206 Phone Number Extension (206) 565-2030 (206) 565-2030 State License Number License Expiration Date SPECICN793OZ 8/31/2025 UBI # E-mail Address FD357F144 permits@speconnw.com Project Location Number Street 7708 196TH ST SW Floor Number Suite or Room Number City Zip Code EDMONDS 98026 County Parcel Number 00891600800100 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Kevin John & Mary Linda Sullivan Number Street 7708 196TH ST SW Apartment or Suite Number A City State EDMONDS WA Zip 98026 Certification Statement - The applicant states: I certify that I am the owner of this property or the owner's authorized agent, including an appropriately licensed contractor. I have furnished true and correct information. I will comply with all provisions of law and ordinances governing this type of construction work, whether specific herein or not. By submitting this application I give the jurisdiction permission to enter the property to perform inspections. I understand that failure to comply with the above may result in revocation of the permit. Date Submitted: 10/31/2023 Submitted By: Nicole Williams Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1397873 Project Type Single Family Residential Project Details Activity Type Repair or Replacement Scope of Work Like for like equipment in the same location Fixtures Shower, Tub or Combo Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) Existing Permits There is no other onsite work that requires a building permit. 1 2nd floor bathroom Scope of Work Plumbing Page 2 of 2