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BLD2024-0770+Application+6.11.2024_2.47.10_PM+4315453CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1499252 - SMC Edmonds Neptune Docking Station Install Applicant First Name Last Name Company Name AMANDA MACGREGOR MacDonald Miller Facility Solutions Number Street Apartment or Suite Number E-mail Address PO Box 47983 City State Zip Seattle WA 98146 Contractor Company Name MACDONALD MILLER FAC SOL INC Number Street 17930 International Blvd. City State Zip SeaTac WA 98188 State License Number License Expiration Date MACDOFS798P9 10/25/2025 Project Location Number Street 21601 76TH AVE W City Zip Code EDMONDS 98026 Associated Building Permit Number Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name permits(D,macmiller.com Phone Number Extension (206) 768-3866 Apartment or Suite Number Suite 120 Phone Number Extension (206) 768-3866 UBI # E-mail Address 602254260 permits(a_macmiller.com Floor Number Suite or Room Number B-FLOOR NONE County Parcel Number 00580700002500 Tenant Name SWEDISH EDMONDS Last Name or Company Name PUBLIC HOSPITAL DISTRICT 2 SNOHOMISH CO Number Street Apartment or Suite Number 4710 196TH ST SW City State Zip LYNNWOOD WA 98036 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: 6/11/2024 Submitted By: AMANDA MACGREGOR Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1499252 - SMC Edmonds Neptune Docking Station Install Project Contact Company Name: MacDonald Miller Facility Solutions Name: AMANDA MACGREGOR Email: permits@macmiller.com Address: PO Box 47983 Phone #: (206) 768-3866 Seattle WA 98146 Project Type Nonresidential Activity Type Repair or Replacement Scope of Work Plumbing Project Name: SMC Edmonds Neptune Docking Station Install Description of Work: Install two (2) water supply and waste boxes for OR docking station equipment (Neptune) and one (1) backflow to serve the two new boxes. Project Details Type of Use Work includes commercial kitchen, food svc, med gas, lab, medical use, or dental use. Additional Project Information Total number of fixtures being added or altered Work Location Work Description/Location (example: 1 st floor, Master Bath, Garage) 9 Install two (2) water supply and waste boxes for OR docking station equipment (Neptune) and one (1) backflow to serve the two new boxes. Page 2 of 2