FIR2020-0086_City_Application_10.19.2020_12.56.09_PMvAC)L"4-Ll "# Z-
BUILDING PERMIT
'~ APPLICATIC.N tin.
DNYelopmen: S—i-s
1OE1..g Di.t n
121 S1h Ave N / Edmonds. WA 95020
/p i, tFpO 425.771.02".1 ActessorY Structure/
rw nw.Mo. n..�.dr..nal,MYwrf./f b: www.aM,wd.wr cay.
r opp'Y7«Prcmc,. ,rnndwr MgMtlM4MMtteJPArercn men
JOB SITE INFORMATION/LOCATION: IWMw the wwk b taWry pLw4
Job Sde Address: Z33Z�i 7Sk e�J9� w% .
P—N:
lot/UNt/SWte 4: Z- SubdiYW-.
SUSIPM OR PROPERTY OWNER:
Name: A Do W, t' JEsk:I T3.JLo lut_
MaiknEAdaese: 1231'�J /•lit Lt,4jdt E...
ckv/wtNaP: S4a CTL_ - WA. 4 c3- I ZS
PAonfP: IUL4PALQQk X,(L 1 0- (Ow>tL•Ldsq
Email: 7.C(e g14c1 ql }JA
OWNERINSTALLAMR: aRYe nod"slen- �.
WA work be pedormed ev the pop" OwT1P ?Qv ms'
I own, reside in, a will —cle In the t V W d SIrYCtae.
InstaW oan n.,.. made on property Mat I own which N not
Intended t« sale, le»e, nmt, or Mhanp aa«d.nB to RCW
1&27.090.
Olwsa sww —:
APPUCANE / erve CONTACTT, N-W',O-IIA"4T�ION' n
NW Appk t: M� �sLW G,,%y
...*Ad&.: ZiA(s IV" --L u .)
CRv(wwm: 5*aC/ t xE�O, w A 5 829Z
Ph— M. 3(OO b(SsL Sl3Cv
E-m.E: LA'Kt.aYY10 aC.W N.ILC I:BTWAIL.Lt7Ll(
4ENER" CnNMAcTOR: Of dNNr.d Ro)m BPpReM)
GMnrN Cgnoattor: �. Ci.J4b Ci s Y.(
MWnSAtldrcss Z�IS (CIS ILV
OwAutyllp: J*+aaJWwn 0.Y1 90z9'Z
Phan A: 3(.0 (�52 SI�Gi
E-0: ..1 to Fl. rl.
STATE URIk fool 1)41 LCZ4O
OTv CNWMONDSRWMWUCDUEt.% 1+1 (V
VIA STATE CONTRACTOR L A I P: (CCR1 A EXPIRATION OATS:
LAU&- T-o 1T Jet
r'] Oetathed Cwye Lj A6MIon
I j 0-moRNon MfcW..l
t] t. nY $IV. F.mwmlow ► .*ft
® Fke Sprk*l. Remodel
❑ New Cpmmerelal/MwedUse O UAW
yLny 13 Tank
❑ Tenant Improvement ❑ DMfr
Rfine"►-11f--bR derC
'ne .on.a of on wr of w«t :.d'e+�se. Mbc«e me WA.a Irovndee ro
,�f rypyn v a a wok evbmenl, mp- o lee}, o+edVee.
and mo ouM •« ma Iwcorw ppJCob .
va wllon:
BeerrNM se R
7rW Hour, se R:
pecs/Ce,f•ed Porcnryetn:
F YI NEw BMreoms. adNEW500—
t�-o ;:4.. SI pals51de_l
Z? iYRrrDS
<ereN wN ae .na.neem n n... rewE.e a w n.ay.P>wano-� :, m.r.
<> Klwmwelr�w..w axl..wl.es«svowra oh ncnwwe
r.nm.a.Pen o.n.w.w,.ra Pnws.xecwlP�re w. tcrw
Pnm NNne: Ar.lO u4e-
swew.: