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BLD2021-0978+Application+7.14.2021_2.12.47_PM+2300561CITY OF EDMONDS Building Application #991190 - Back Yard Patio Applicant First Name Last Name Raine Liqhtner Number Street Apartment or Suite Number 21310 82nd PL W City State Zip Edmonds WA 98026 Contractor Company Name Contractor Unknown Number Street City State Zip State License Number License Expiration Date UBI # Project Location Number Street 21310 82ND PL W City Zip Code County Parcel Number EDMONDS 98026 00467400001100 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions). Work Location Property Owner MyBoildingPermit.com Company Name E-mail Address rlightner(�D_gmail.com Phone Number Extension 2063536361 Apartment or Suite Number Phone Number Extension E-mail Address Floor Number Suite or Room Number First Name Last Name or Company Name Raine Liqhtner Number Street Apartment or Suite Number 21310 82nd PL W City State Zip Edmonds WA 98026 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: 7/14/2021 Submitted By: Raine Lightner Page 1 of 2 i CITY OF EDMONDS MyBui[di ngPerrnit.com Building Application #991190 - Back Yard Patio Project Contact Company Name: Name: Address: Raine Lightner 21310 82nd PL W Edmonds WA 98026 Project Type Single Family Residential Email: rightner@gmail.com Phone #: 2063536361 Activity Type Deck or Porch Project Name: Back Yard Patio Description of Work: Removing some sod, and laying down a patio with drain to exiting Drywell Project Details Structure Type Deck Project Information Square Feet - Deck 1,100 Page 2 of 2