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BLD2024-0882+Application+7.8.2024_10.41.22_AM+4361589CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1513817 -Lake Scriber School Applicant First Name Last Name Company Name Patrick Dickinson Service Plumbinq and Heatinq Inc Number Street Apartment or Suite Number E-mail Address 2100 196th St SW info(LD_serviceph.net City State Zip Phone Number Extension Lynnwood WA 98036 (425) 640-2121 Contractor Company Name SERVICE PLUMBING & HEATING INC Number Street Apartment or Suite Number 2100 196th St SW City State Zip Phone Number Extension Lynnwood WA 98036 (425) 640-2121 State License Number License Expiration Date UBI # E-mail Address SERVIPH797NR 11/3/2025 602238671 info(aD_serviceph.net Project Location Number Street Floor Number Suite or Room Number 23200 100TH AVE W 1 Staff Lounqe City Zip Code County Parcel Number EDMONDS 98020 27033600202200 Associated Building Permit Number Tenant Name BLD2024-0345 Lake Scriber School Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name EDMONDS SCHOOL DIST 15 Number Street Apartment or Suite Number 20420 68TH AVE W City State Zip LYNNWOOD WA 98036-7405 Certification Statement - The applicant states: 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. 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: 7/8/2024 Submitted By: Patrick Dickinson Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1513817 -Lake Scriber School Project Contact Company Name: Service Plumbing and Heating Inc Name: Patrick Dickinson Email: derek@serviceph.net Address: 2100 196th St SW Phone #: (425) 640-2121 Lynnwood WA 98036 Project Type Nonresidential Activity Type New Scope of Work Plumbing Project Name: Lake Scriber School Description of Work: add toilet, lavatory and floor drain with trap primer to staff lounge. there is an existing bathroom that we will be tying into about 6' away. Project Details Scope of Work Plumbing Fixtures for Building Permit Type of Use Work does NOT have med gas, commercial kitchen, food svc, lab, medical, or dental use. Associated Building Permit? There is or will be a building permit associated with this work at the project location. Additional Project Information Total number of fixtures being added or altered Work Location Work Description/Location (example: 1 st floor, Master Bath, Garage) 3 We will be adding 1 toilet, 1 lavatory and one floor drain with trap primer. these will be installed about 6' from existing bathroom. this is a private school. Page 2 of 2