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BLD2021-0344+Application+3.8.2021_6.09.48_AM+2079932CITY OF EDMONDS MyBuildingPermit.com Building Application #931620 - Fiore Addition & Remodel Applicant First Name Last Name Company Name Michael Fiore Number Street Apartment or Suite Number E-mail Address 9401 215th St SW tom(�D_lerendesign.com City State Zip Phone Number Extension Edmonds WA 98020 (206) 954-4145 Contractor Company Name Haider Construction Number Street Apartment or Suite Number 5607 244th St. SW City State Zip Phone Number Extension Mountlake Terrace WA 98043 4257713515 State License Number License Expiration Date UBI # E-mail Address HAIDEC*914DB 4/5/2021 602903374 tom@lerendesign.com Project Location Number Street Floor Number Suite or Room Number 9401 215TH ST SW City Zip Code County Parcel Number EDMONDS 98020 00496100000200 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name Michael Fiore Number Street Apartment or Suite Number 9401 215TH 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: 3/8/2021 Submitted By: Michael Fiore Page 1 of 2 CITY OF EDMONDS M BuildingPerrnit.com Building Application #931620 - Fiore Addition & Remodel Project Contact Company Name: PLCet Sound Planning, Name: Lee Michaelis Address: 5005 200th St SW Suite 101-B Lynnwood WA 98036 Project Type Single Family Residential Email: lee.michaelis@pugetsoundplanning.com Phone #: 4258301046 Activity Type Scope of Work Structure Addition Residence Project Name: Fiore Addition & Remodel Description of Project includes the construction of a 293 square foot first floor addition to include new Work: kitchen, laundry room and mud room. Project also includes construction of a new 20 square foot entryway. Project Details Increasing Building Height? The height of the building is not increasing. Impervious Surface Adding/Replacing less than 2,000 square feet of hard surface Site Information Lot size in square feet Proposed Lot Coverage as a percentage There are no critical areas. Clearing and Grading Information Total cubic yards of cut and fill Mechanical Included? Mechanical work will occur during this project. Plumbing Included? Plumbing work will occur during this project. Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) Valuation Fair Market Value of Construction Work Beam, Column or Footing Relocation or addition of a structural beam, column, or footing Heated Space The work involves adding any new heated space 10845 19.2 4 First Floor east side of existing structure $85,000 Page 2 of 2