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BLD2021-1383_Application_10.7.2021_11.28.33_AM_2450236CITY OF EDMONDS MyBuildingPermit.com Building Application #1031351 -Seismic Retrofit Close -Out Applicant First Name Last Name Company Name Jehiel Baer Number Street Apartment or Suite Number E-mail Address 10408 231 st St. SW jehielbaer@gmail.com City State Zip Phone Number Extension Edmonds WA 98020 4438785585 Contractor Company Name SEISMIC NORTHWEST LLP Number Street Apartment or Suite Number 6430 131 ST AVE SE City State Zip Phone Number Extension BELLEVUE WA 98006 (831)566-5535 State License Number License Expiration Date UBI # E-mail Address SEISMNL840CJ 2/12/2022 F;ni_r,_r).r)91:1 jehielbaer@gmail.com Project Location Number Street Floor Number Suite or Room Number 10408 231 ST ST SW Basement and All City Zip Code County Parcel Number EDMONDS 98020 00426100000900 Associated Building Permit Number Tenant Name BLD2019-0254 Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Jehiel Isaac Baer Number Street Apartment or Suite Number 10408 231 ST ST SW 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: 10/7/2021 Submitted By: Jehiel Baer Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Building Application #1031351 - Seismic Retrofit Close -Out Project Contact Company Name: Name: Jehiel Baer Email: jehielbaer@gmail.com Address: 10408 231st St. SW Phone #: 4438785585 Edmonds WA 98020 Project Type Activity Type Any Project Type Preapplication Services Project Name: Seismic Retrofit Close -Out Description of Work: Applying for permit to close out your expired permit Project Details Work Location Work Description/Location (example: 1 st floor, Basement --closing out expired permit. Master Bath, Garage) Page 2 of 2