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BLD2024-0635_Application_5.10.2024_5.32.18_PM_4251196CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1438982 - Bixler Art Studio Applicant First Name Last Name Company Name Staci Bixler Number Street Apartment or Suite Number E-mail Address 23629 102nd PI W stacibixler@gmail.com City State Zip Phone Number Extension Edmonds WA 98020 (206) 979-0796 Contractor Company Name Owner Number Street Apartment or Suite Number City State Zip Phone Number Extension State License Number License Expiration Date UBI # E-mail Address Project Location Number Street Floor Number Suite or Room Number 23629 102ND PL W City Zip Code County Parcel Number EDMONDS 98020 00405800001500 Associated Building Permit Number Tenant Name BLD2024-0197 Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Eric P & Staci A Bixler Number Street Apartment or Suite Number 23629 102ND PL W City State Zip EDMONDS WA 98020 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: 5/10/2024 Submitted By: Staci Bixler Page 1 of 2 i CITY OF EDMONDS MyBuitdingPermit.com Plumbing Application #1438982 - Bixler Art Studio Project Contact Company Name: Name: Address: Staci Bixler 23629 102nd PI W Edmonds WA 98020 Email: stacibixler@gmail.com Phone #: (206) 979-0796 Project Type Activity Type Scope of Work Single Family Residential New Plumbing Project Name: Bixler Art Studio Description of Work: Adding bathroom to out -building with connection to existing systems. Project Details Scope of Work Plumbing Fixtures for Building Permit Fixtures Shower, Tub or Combo Toilet Sinks Sink Piping Piping - Water Service Water Supply Piping 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 1 Adding bathroom with extension of building drain to existing system. Page 2 of 2