BLD2020-0750+City_Application+7.21.2020_9.44.22_PM+" r'. 101
BUILDING PERMIT
APPLICATION
Development Services
Building Division
121 5th Ave fV / Edmonds, WA 98020
425, 771.0220
For handozits, Submittal requirements go to. www.edmundswu. ❑v.
To apply for permits, schedule inspections, or check oppfication status
go tn: www.mybuifdingpermit.com
JOB SITE IN (Where the work is taking place)
Job Site Address: 16211 70th PI W
Parcel: 0064 5000 0600
Lot /Unit/Suite #: -6 _ _ Subdivision:_
BUSINESS OR PROPERTY OWNER:
Name- Chris Foster
Mailing Address: 16211 70th PI W
city/5tate/zip: Edmonds, Wa, 98026
Phone #: 206 369 5122
Email: cfoster45@gmail.com
OWNER INSTALLATION: *If yes, read and sign•
Will work be performed by the property owner?Fv_1YesF_1 No
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.ago.
Owner Signature:
APPLICANT / CONTACT INFORMATION:
Name of Applicant: Chris Foster
Mailing Address: 16211 70th PI W
city/state/zip: Edmonds, Wa, 98026
Phone #: 206 369 5122
E-mail: CfOSter45@grnail.COrn
GENERAL CONTRACTOR: (If different from applicant)
General Contractor:
Mailing Address.
City/State/Zip:
Phone #:
E-mail:
STATE USI M:
CITY OF EDMONDS BUSINESS LICENSE M:
WA STATE CONTRACTOR L & I R: (CCB) & EXPIRATION DATE
Pgrmit II:
Accessory Structure/
F-1 Addition
Detached Garage
f
Mechanical
Demolition
❑
New Single Family/Duplex
❑ Plumbing
Fire Sprinkler
� Remodel
New Commercial/Mixed Use
Re -Roof
Signs
Tank
Tenant Improvement
other
FOIL A Z-
Remodel Rermtt 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: $50,000
PROPOSED NEW 5QUARE FOOTAGE FOR THIS APPLICATION
Basement sq It: Finished ElUnfinished
1st Floor, sq ft=
2nd Floor, sq ft:
Garage/Carport , sq ft:
316
deck/Covered Porch/Patio-_
# of NEW Bedrooms_
PROJECT
# of NEW Bathrooms:
DE5CRIPTION
I certify that Of! Information I have prouided on this form/application is true,
correct and complete, and that I am the property owner fir duly authorized
agent of the property owner to submit a permit applleation to the City of j}+.
Edmonds. ;
Print Narne: Chris Fo er
Signature: Date Z1
Ii