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BLD2021-1326+Application+9.28.2021_10.32.11_AM+2432293CITY OF EDMONDS Building Application #1026371 - New fence Applicant First Name Last Name Kayla Nichols Number Street Apartment or Suite Number 16531 13th Ave W Ste. A107 City State Zip Lynnwood WA 98037 Contractor Company Name Select homes inc Number Street 16531 13th ave w City State Zip Lynnwood WA 98037 State License Number License Expiration Date UBI # SELECH1110KN 1/2/2023 601148280 Project Location Number Street 18828 SOUND VIEW PL MyBuildingPermit.com Company Name Select Homes, Inc. E-mail Address kayla.clark(D_outlook.com Phone Number Extension 4257426044 Apartment or Suite Number A 107 Phone Number Extension (425) 742-6044 E-mail Address kayla.clark(cb_outlook.com City Zip Code County Parcel Number EDMONDS 98020 00498400000200 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Floor Number Suite or Room Number First Name Last Name or Company Name CLARK TRUST RANDY N & JUDY L & CLARK RANDY Number Street Apartment or Suite Number 16531 31 ST AVE W A107 City State Zip LYNNWOOD WA 98037 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: 9/28/2021 Submitted By: Kayla Nichols Page 1 of 2 i CITY OF EDMONDS MyBui[di ngPerrnit.com Building Application #1026371 - New fence Project Contact Company Name: Select Homes, Inc. Name: Kayla Nichols Email: kayla.clark@outlook.com Address: 16531 13th Ave W Ste. A107 Phone #: 4257426044 Lynnwood WA 98037 Project Type Single Family Residential Activity Type New Construction Project Name: New fence Description of Work: new cedar fence along east and south property lines Project Details Work Location Work Description/Location (example: 1 st floor, New cedar fence Master Bath, Garage) Scope of Work Fence Page 2 of 2