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BLD2021-0200+Application+2.3.2021_4.03.27_PM+2031785CITY OF EDMONDS M BtaildingPermit.com Building Application #918420 - Replace and expand backyard concrete patio Applicant First Name Last Name Company Name Rose Drew Number Street Apartment or Suite Number E-mail Address 810 12 ave In Iizzyd3WD_yahoo.com City State Zip Phone Number Extension Edmonds WA 98020 2063109091 Contractor Company Name Contractor Unknown Number Street Apartment or Suite Number City State Zip Phone Number Extension State License Number License Expiration Date UBI # E-mail Address Project Location Number Street Floor Number Suite or Room Number 810 12TH AVE N City Zip Code County Parcel Number EDMONDS 98020 00507000000200 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name RED ORCA LLC Number Street Apartment or Suite Number 810 12TH AVE N City State Zip EDMONDS WA 98020 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: 2/3/2021 Submitted By: Rose Drew Page 1 of 2 i CITY OF EDMONDS MyBui[di ngPerrnit.com Building Application #918420 - Replace and expand backyard concrete patio Project Contact Company Name: Name: Address: Rose Drew 81012aven Edmonds WA 98020 Project Type Single Family Residential Email: lizzyd30@yahoo.com Phone #: 2063109091 Activity Type Deck or Porch Project Name: Replace and expand backyard concrete patio Description of Work: Remove current -180 sq ft patio and replace with new --430 sq ft concrete patio Project Details Structure Type Deck Project Information Square Feet - Deck 432 Page 2 of 2