BLD2020-0680+City_Application+7.1.2020_10.38.35_PMO�V�M
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BUILDING PERMIT
APPLICATION
Development Services
Building Division
121 5th Ave N Edmonds... WA 98020
425.7711 *0220
For handouts, submittal requirements go to: www. edmonds wa. go
To apply for permits, schedule inspections, or check application status
go to: www, mvburldino
ermit.com
JOB SITE INFORMATION/LOCATION!, (Where the work is taking place)
fob Site Address: 845 DLayton St
Parcel: 00434207702500
Lot /Unit/Suite #: 9c; A 99 1 Subdivision: P_0
BUSINESS OR PROPERTY OWNER:
Name: Chee and Sherlyn Wong
MailingAddress: 845 Dayton St
City/State/Zip: Edmonds, WA 98020
Phone #: 206 383 5031
Emaik sherlynchan@gmail.com
OWNER INSTALLATION: *If yes, read and sign*
Will work be performed by the property owner.? R]Yes 1:1 No
1 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
18.27.0900
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Owner Signature:
APPLICANT / CONTACT INFORMATION:
Name of Applicant: Sherlyn Wong
Mailing Address: 845 NO ---------------- Da
on St
pity/state/zip: Edmonds, WA 98020
Phone #: 206 383 5031
E-mail: Sherlynchan@gmail.com
OWN
GENERAL CONTRACTOR: (If different from applicant)
General Contractor:
Mailing Address:
City/State/Zip:
Phone #:
E-mail,0
STATE UBI #910
CITY OF EDMONDS BUSINESS LICENSE #:
WA STATE CONTRACTOR L & I #6, (CCB) & EXPIRATION DATE:
Permit #
TYPE OF PERMIT (Provide Details on Page 2)
Accessory Structure/
_ Detached garage Addition
El
Demolition Mechanical
El
ElNew Single Family/Duplex Plumbing
E:1 Fire Sprinkler Remodel
Fl! New Commercial/Mixed Use Re -Rood
E:1 Signs El Tank
Tenant Improvement Other
Remodel Permit fees are based on:
The value of the work performed. Indicate the value grounded to
the nearest dollar) of all equipment, materials, labor.. overhead,
and the profit for the work indicated on this application.
Valuation: 6,000.00 -
PROPOSED NE SQUARE FOOTAGE FOR THIS APPLICATION
Basement sq ft; FinishedEl Unfinished E:1
1st Floor, sq ft:
end Floor, sq ft: �
Garage/carport:, sq ft:
Deck/Covered Parch/Patio:
# of NEW Bedrooms: # of NEW Bathrooms:
PROJECT DESCRIPTION
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LAM
I certify that the information I have provided an this form/application is true,
correct and complete, and that I am the property owner or duly authorized
agent of the property owner to submit a permit application to the City of
Edmonds.
Print Name,. Sheri�n Won9
Signature: Date 7/1/2020
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