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BLD2020-1063+Application+10.7.2020_5.23.54_PMCITY OF EDMONDS Building Application #869411 - Fence Repair Applicant First Name Last Name Jacquelyn Johnson Number Street Apartment or Suite Number 550 DAYTON 102 City State Zip EDMONDS WA 98020 Contractor Company Name TOWN & COUNTRY FENCE INC Number Street 6410 212TH SW City LYNNWOOD State License Number TOWNCF*344L7 Project Location Number Street 550 DAYTON ST City EDMONDS Associated Building Permit Number MyBuildingPermit.com Company Name E-mail Address iiohn98365(D_gmail.com Phone Number Extension 4256781906 Apartment or Suite Number State Zip Phone Number Extension WA 98036 4257750531 License Expiration Date UBI # E-mail Address 3/6/2022 319009081 iiohn98365(c_gmail.com Floor Number Suite or Room Number 1 102 Zip Code County Parcel Number 98020 01024600010200 Tenant Name Jacquelyn Johnson Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name Georqe M & Jacquelyn M Johnson Number Street Apartment or Suite Number 550 DAYTON ST 102 City State Zip EDMONDS WA 98020-3629 Certification Statement - The applicant states: I 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. I 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: 10/7/2020 Submitted By: Jacquelyn Johnson Page 1 of 2 i CITY OF EDMONDS MyBui[di ngPerrnit.com Building Application #869411 - Fence Repair Project Contact Company Name: Name: Jacquelyn Johnson Email: jjohn98365@gmail.com Address: 550 Dayton Street #102 Phone #: 4256781906 EDMONDS WA 98020 Project Type Activity Type Nonresidential New Construction Project Name: Fence Repair Description of Work: replace damaged existing fence Project Details Structure Type Fence Scope of Work Fence Page 2 of 2