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Application_1401697CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1401697 Applicant First Name Last Name Company Name Quiana Williams Jacuzzi Bath Remodel of Seattle Number Street Apartment or Suite Number E-mail Address 8330 S 259th St quiana.williams@jacuzzi.com City State Zip Phone Number Extension Kent WA 98030 (253) 625-9168 Contractor Company Name JACUZZI BATH REMODEL OF SEA Number Street Apartment or Suite Number 8330 S 259th St City State Zip Phone Number Extension Kent WA 98030 (253) 625-9168 State License Number License Expiration Date UBI # E-mail Address JACUZBR787P8 11/18/2024 BD47.snnR4 quiana.williams@jacuzzi.com Project Location Number Street Floor Number Suite or Room Number 9122 BOWDOIN WAY City Zip Code County Parcel Number EDMONDS 98026 00373600600318 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 Farrokh Kazemian Number Street Apartment or Suite Number 9122 BOWDOIN WAY 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, 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: 11/8/2023 Submitted By: Quiana Williams Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1401697 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 Master bath first floor Scope of Work Plumbing Page 2 of 2