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Application_1278165CITY OF EDMONDS M BuildingPermit.com Plumbing Application #1278165 Applicant First Name Last Name Nicole Williams Company Name Pacific Bath Company Number Street 17880 NE Airport Way Apartment or Suite Number E-mail Address 110 jgreer@pacificbath.com City State Zip portland OR 97230 Phone Number Extension (971) 264-0145 Contractor Company Name PACIFIC BATH COMPANY Number Street 6521 SE CROSSWHITE WAY Apartment or Suite Number A City State Zip PORTLAND WA 97206 Phone Number Extension (206)565-2030 (206)565-2030 State License Number License Expiration Date SPECICN793OZ 8/31/2023 UBI # E-mail Address FD357F144 jgreer@pacificbath.com Project Location Number Street 8219 TALBOT RD Floor Number Suite or Room Number City Zip Code EDMONDS 98026 County Parcel Number 00594400001000 Associated Building Permit Number PB20584 Tenant Name Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Robert Bernhoft Number Street PO BOX 6113 Apartment or Suite Number City State EDMONDS WA Zip 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: 3/6/2023 Submitted By: Nicole Williams Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Plumbing Application #1278165 Project Type Single Family Residential Project Details Fixtures Shower, Tub or Combo Associated Building Permit? Activity Type Repair or Replacement There is no other onsite work that requires a building permit. Work Location Scope of Work Plumbing Work Description/Location (example: 1st floor, Remove shower/tub combo install Walk in Bath using Master Bath, Garage) existing foot print and plumbing Page 2 of 2