BLD2020-1065_City_Application_10.8.2020_12.35.47_PM"4c. 1'0"
BUILDING PERMIT
APPLICATION
Development Services
Building Division
121 5th Ave N / Edmonds, WA 98020
425.771.0220
For handouts, submittal requirements go to: www.edmondswa.aov.
To apply for permits, schedule inspections, or check application status
go to: www.mvbuildinapermit.com
JOB SITE INFORMATION/LOCATION: (Where the work is taking place)
Job Site Address: 20OJames St.
Parcel: 00678200010100
Lot /Unit/Suite#:101 Subdivision:
BUSINESS OR PROPERTY OWNER:
Name: El Capitan HOA
Mailing Address: 200 James St.
City/State/Zip: Edmonds, Wa, 98020
Phone #: 206-551-0651
Email:
OWNER INSTALLATION: *If yes, read and sign*
Will work be performed by the property owner?❑YesFv]No
I own, reside in, or will reside in the completed structure. This
installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange according to RCW
18.27.090.
Owner Signature:
APPLICANT / CONTACT INFORMATION:
Name of Applicant: RES Graphics
Mailing Address: 1 37th St. #E
City/State/Zip: Auburn, W. 98001
Phone #: 206-439-8555
E-mail: ramlyn@ramlyn.com
GENERAL CONTRACTOR: (If different from applicant)
General Contractor:
Mailing Address:
City/State/Zip:
Phone #:
E-mail:
STATE UBI #: 603160605
CITY OF EDMONDS BUSINESS LICENSE #: iFE14 0I KC'7
WA STATE CONTRACTOR L & I #: (CCB) & EXPIRATION DATE:
71508448 Continuous
Offis-e Use Only
TYPE OF PERMIT (Provide
Accessory Structure/
Detached Garage
Details
Addition
Demolition
Mechanical
New Single Family/Duplex
Plumbing
Fire Sprinkler
Remodel
New Commercial/Mixed Use
Re -Roof
Signs
❑ Tank
ElTenant Improvement
❑ Other
Remodel Permit fees are based on:
The value of the work performed. Indicate the value (rounded to
the nearest dollar) of all equipment, materials, labor, overhead,
and the profit for the work indicated on this application.
Valuation:
PROPOSED NEW SQUARE FOOTAGE FOR THIS APPLICATION
Basement scl ft: Finished❑ Unfinished ❑
1st Floor, sq ft:
2nd Floor, sgft:
Garage/Carport:, scl ft:
Deck/Covered Porch/Patio:
# of NEW Bedrooms: # of NEW Bathrooms:
PROJECTDESCRIPTION
I certify that the information I have provided on this form/application is true,
correct and complete, and that I am the property owner or duly authorized
agent of the property owner to submit a permit application to the City of
Edmonds.
Print Name: n a Simoneu
Signature: Date 1 0/6/20