BLD2020-1417+City_Application+12.30.2020_11.35.15_PM+1968709BUILDING PERMIT
APPLICATION Permit#:
D el t S
ev opmen ervtces
BuHding Division
121 5th Ave N / Edmonds, WA 98020
425.771.0220
For handouts, submittal requirements go to: www.edmondswo.aov.
To apply for permits, schedule inspections, or check application status
go to: www.mvbulidinavermit.com
JOB SITE INFORMATION/LOCATION: (Where the work is taking place)
Job Site Address: 8704 242nd St SW 98026
Parcel:
Lot /Unit/Suite #: Subdivision:
BUSINESS OR PROPERTY OWNER:
Name: Shane & Ken'i Ratigan
Mailing Address: 8704 242nd St SW
City/State/Zip: Edmonds, WA 98026
Phone #: 206 402 2451
Email: shane.ratigan@gmail.com
OWNER INSTALLATION: 'If yes, read and sign*
Will work be performed by the property owner? R Yes ❑ No
1 own, reside in, or will reside in the completed structure. This
installation is being made on property that wn which is not
intended for sal e, r or excha a according to RCW
18.27.090.
Owner Signatu
APPLICANT / CONTACT INFORMATION.
Name of Applicant: Shane Ratigan
Mailing Address: 8704 242nd St SW
city/state/zip: Edmonds, WA 98026
Phone #: 206 402 2451
E-mail: shane.ratigan@gmail.com
GENERAL CONTRACTOR: (if different from applicant)
General Contractor:
Mailing Address:
City/State/Zip:
Phone #:
E-mail:
STATE UBI #:
CITY OF EDMONDS BUSINESS LICENSE #:
WA STATE CONTRACTOR L & I #: (CCB) & EXPIRATION DATE:
TYPE OF PERMIT (Provide
Accessory Structure/
Detached Garage
Details on Page 2)
Addition
El
Demolition
Mechanical
ElNew Single Family/Duplex
Plumbing
ElFire Sprinkler
Remodel
New Commercial/Mixed Use
Re -Roof
11 Signs
❑ Tank
❑ Tenant improvement
❑ Other
Remodel Permit 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: $1000.00
PROPOSED•UARE FOOTAGE FOR THIS A" •
Basement sq ft: Finished ❑ Unfinished
1st Floor, sq ft;
2nd Floor, sgft:
Garage/Carport:, sq ft:
Deck/Covered Porch/Patio:
# of NEW Bedrooms: # of NEW Bathrooms:
PROJECT•
1 certify that the information I have provided on 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: Shane Ratigan
Signature: Date 12/30/20