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BLD2024-0331_Application_3.11.2024_10.58.19_AM_4117798CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1455604 - Lantz Applicant First Name Last Name Company Name eric Shirley Shirley plumbing Number Street Apartment or Suite Number E-mail Address 25001 summit dr mr.ericshirley@gmail.com City State Zip Phone Number Extension Black Diamond WA 98010-9400 (206) 355-9638 Contractor Company Name SHIRLEY PLUMBING LLC Number Street Apartment or Suite Number 25001 SUMMIT DR City State Zip Phone Number Extension BLACK DIAMOND WA 98010 (206) 355-9638 State License Number License Expiration Date UBI # E-mail Address SHIRLPL789NB 7/19/2024 BD4,i171g5 mr.ericshirley@gmail.com Project Location Number Street Floor Number Suite or Room Number 8714 TALBOT RD City Zip Code County Parcel Number EDMONDS 98026 00594400005502 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 Brett & Kathy Lantz Number Street Apartment or Suite Number 8714 TALBOT 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: 3/11/2024 Submitted By: eric Shirley Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1455604 - Lantz Project Contact Company Name: Shirley plumbing Name: eric Shirley Email: mr.ericshirley@gmail.com Address: 25001 summit dr Phone #: (206) 355-9638 Black Diamond WA 98010-9400 Project Type Single Family Residential Activity Type Alteration Project Name: Lantz Description of Work: Remodel Kitchen and powder room Project Details Scope of Work Plumbing Fixtures for Building Permit Fixtures Dishwasher Ice Maker Toilet Sinks Sink Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) Existing Permits There is or will be a building permit associated with this work at the project location. 1 1 1 3 kitchen area Scope of Work Plumbing Page 2 of 2