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BLD2021-0870+Application+6.22.2021_12.56.07_PM+2263047CITY OF EDMONDS MyBuilaingPermit.com Building Application #980851 - Gundersen House Addition Applicant First Name Last Name Company Name Scott Boyer Mithun Number Street Apartment or Suite Number E-mail Address 12216 Corliss Avenue North scottb((_mithun.com City State Zip Phone Number Extension Seattle WA 98133 2062350935 Contractor Company Name Contractor Unknown Number Street Apartment or Suite Number City State Zip Phone Number Extension State License Number License Expiration Date UBI # E-mail Address Project Location Number Street Floor Number Suite or Room Number 7811 200TH ST SW City Zip Code County Parcel Number EDMONDS 98026 27041900102600 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 Edward & Michelle Gundersen Number Street Apartment or Suite Number 7811 200TH ST SW City State Zip EDMONDS WA 98026-6834 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: 6/22/2021 Submitted By: Scott Boyer Page 1 of 2 CITY OF EDMONDS M BuildingPerrnit.com Building Application #980851 - Gundersen House Addition Project Contact Company Name: Mithun Name: Scott Boyer Email: scottb@mithun.com Address: 12216 Corliss Avenue North Phone #: 2062350935 Seattle WA 98133 Project Type Single Family Residential Activity Type Scope of Work Structure Addition Residence Project Name: Gundersen House Addition Description of Work: 215 SF dining room addition to existing single story home. Work to include kitchen remodel. Project Details Project Information Square Feet - of Attached ADU 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 There are no critical areas. Clearing and Grading Information Total cubic yards of cut and fill Mechanical Included? No 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 No relocation or addition of a structural beam, column, or footing 215 L 1 st floor dining room addition & kitchen remodel including overframed roof (existing home roof to remain) over new addition $50,000 Page 2 of 2