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ApplicationCITY OF EDMONDS M BuildingPermit.com Building Application #1040449 - Meadowdale Beach Adult Family Home Applicant First Name Last Name Company Name Moqes Girmay Meadowdale Beach Adult Family Home Number Street Apartment or Suite Number E-mail Address 6907 Meadowdale beach rd mogesgirmay(D_gmail.com City State Zip Phone Number Extension Edmonds WA 98026 2062145211 Contractor Company Name Owner Number Street Apartment or Suite Number City State License Number Project Location State Zip License Expiration Date UBI # Number Street 6907 MEADOWDALE BEACH RD City Zip Code County Parcel Number EDMONDS 98026 00751500000400 Associated Building Permit Number Tenant Name 1038204 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Phone Number Extension E-mail Address Floor Number Suite or Room Number First Name Last Name or Company Name Moqes T Sr & Birru Sara G Girmay Number Street Apartment or Suite Number 17110 67TH AVE 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: 10/26/2021 Submitted By: Moges Girmay Page 1 of 2 i CITY OF EDMONDS MyguildingPermit.com Building Application #1040449 - Meadowdale Beach Adult Family Home Project Contact Company Name: Meadowdale Beach Adult Family Home Name: Moges Girmay Email: mogesgirmay@gmail.com Address: 6907 Meadowdale beach rd Phone #: 2062145211 Edmonds WA 98026 Project Type Single Family Residential Activity Type Adult Family Home Inspection Only Project Name: Meadowdale Beach Adult Family Home Description of I installed grab bars in bathrooms cost $525 1 replaced all the tile in the bathrooms cost $ Work: 2550 Installed rail to the entry $2349 Total expense for all the work and materials $ $5514 Project Details Project Information Number of Caretaker Bedrooms 1 Number of Client Bedrooms 5 Page 2 of 2