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BLD2020-1153+City_Application+10.27.2020_2.03.12_PMBJlしDiNG PERMIT APPしICATION DeveIopmen† §ervice§ BuiIding Division 121 5†h Ave N / Edmonds, WA?8O2O 425.771.02ま0 for hondout5, 5ubmi競O/ ′equi化ments go to; WWW. edmondswa.oov. 7b applyJb′ pemi屯, Schedu/c ;nspectjon5, O′ check app伽の蹄on s的tus go to; ±塑卑mybui/dinoβemi書. com 」OBSITEINFORMATiON/しOCAT10N:(Whe「etheworkistakingpIace) 」obSiteAddress:1882480THAVEW Parcei:OO4816OOlOO300 しOt/Unit/Suite♯:    Subdivision: BUSINESSORPROPERTYOWNER: Name:MODUSPROPER丁YLLC MaiiingAddress:3225T…eCreekBIvd#1653 city/State/Zip:DALLAS’TX75219 ph。ne#:(425)457-0298 Email:SteVeghio@gmaii.com 0岩盤器岩島誓書咽Yes□N。 Iown,reSidein,OrW紺resideinthecompIetedstructure,This insta=ationisbeingmadeonpropertythatIownwhichisnot intendedforsaie,lease,rent,OreXChangeaccordingtoRCW 18.27.090. 。wn。.Signa,u嶋:±zZ三越と/易しくA多>      ∠/ APPしiCANT/CONTACTINFORMATION: NameofAppIicant:K「uege「K「a冊ngLLC Ma冊gAdd「ess:2290158thAve・W" City/State/Zip:MountIakeTe「「ace,WA98O43 phone#‥206-819-2710 E_ma出 greg@kruegerkraftng.com GENERAしCONTRACTOR:(ifdifferentfromappiicant) GeneralContractor:J&ArtContracto「sLLC Ma冊gAddress:160OINE6thst city/State/Zip:BeIIevue’WA980O8 phone♯:206538-1419 E_mail:jfiua「ez99@yahoo.com s丁A丁各U馴♯:603180200 ciTYOFEDMONDSBUSINESSLICENSE#:16822235 WASTAT各CONTRAC丁ORし&i榊(CCB)&EXPIRATIONDATE: JAR丁CAC83OC7 Accessory Structure/ Detached Garage DemoIition New SingIe FamiIy/DupIex Fire SprinkIer New Commercial/Mixed Use Tenant improvement Remodel Perm柵fee§ are based on: The vaiue of †he work performed. indica†e †he value (rounded †o †he neares† d01iar) of ail equipmen†. ma†eriais, labor. overhead, and †he p「O硝for †he wo「kindica†ed on冊S aPPiica†ion. VaIua†ion: 500OO B∂Sement Sq ft: Finished団unfinished□ 1st FIoor, Sq ft: 2nd FIoor, Sqft: Garage/Carport:, Sq ft: Deck/Covered Porch/Patio: # of NEW Bedrooms: 2 #of NEW Bathrooms: 1 ′マク旬御ノダ1ケ〃V 勿〆/砂〃〃 戸乞う珍々 〃ルD 孝/ルル方〃Vメタ 虜雅雄緋了の/1偽汐1 ル砂クi声ナノ/脇 〃〃ソティ往々紡形 色揚4為所 d戸イ〃〆〃クU5〆,タイDD夙/宏 ア 叙力傍/イ カ イン疹屈筋多極ク招イ"/L∠ /みブ夜レ移孝 z 砂左∠Z ん〆ノ,沈カルタ, ,後少のク∠ ̄で 砂/〆雅之の諦イれ/V5乃イみ疹: "ゑ多彩 バ戸イ〃乏 考の′老 I cer寄fy thatthe info「matうon l have provided on this fom/application is true, correct and compiete. and that l am the propertY OWner Or duly authorized agent of the property owne「 to submit a permit appiication to the Citγ Of 師ntName: G/宅を6 K/孔/乞多G々 Signature: