BLD2021-1341+Application+9.29.2021_11.21.02_AM+2431189CITY OF EDMONDS nnyst,ilaingPermit.com
Building Application #1026029 - ChildressHart Home
Applicant
First Name Last Name Company Name
Matthew Hart
Number Street Apartment or Suite Number E-mail Address
22050 99th PL W childresshart(.@_gmail.com
City State Zip Phone Number Extension
Edmonds WA 98020 2069794315
Contractor
Company Name
Owner
Number Street
City
State License Number
Project Location
State Zip
License Expiration Date UBI #
Number Street
22050 99TH PL W
City Zip Code County Parcel Number
EDMONDS 98020 00602100100700
Associated Building Permit Number Tenant Name
BLD2021-0971,
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
Apartment or Suite Number
Phone Number Extension
E-mail Address
Floor Number Suite or Room Number
First Name Last Name or Company Name
Matthew A & Childress Bethany A Hart
Number Street Apartment or Suite Number
22050 99TH PL W
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: 9/29/2021 Submitted By: Matthew Hart
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CITY OF EDMONDS MyBuildingPermit.com
Building Application #1026029 - ChildressHart Home
Project Contact
Company Name:
Name:
Address:
Matthew Hart
22050 99th PL W
Edmonds WA 98020
Project Type
Single Family Residential
Project ChildressHart Home
Name:
Email: childresshart@gmaiI.com
Phone #: 2069794315
Activity Type Scope of Work
Remodel Residence
Primary Bath Remodel & Primary Bedroom Entry revised (closet added & entry relocated),
Miscellaneous Exterior Walls opened (wall panel removed) for electrical rewire - insulation being
replaced where wall opened. Adding non-structural walls at Rec Room and in Basement for an
Description mud room / storage and den. Please note mechanical and plumbing work is being performed
of Work: under separate permits, see permit numbers below: BLD2021-0971 - Gas Piping BLD2021-0972
- Plumbing for new hot water heater and multiple fixture replacements BLD2021-1278 - Master
Bath Remodel (Plumbing Only) BLD2021-1302 - Furnace Replacement (old furnace - heating oil,
new furnace - natural gas)
Project Details
Mechanical Included?
No mechanical work will occur during this project.
Plumbing Included?
No plumbing work will occur during this project.
Work Location
Work Description/Location (example: 1st floor,
Master Bath, Garage)
Valuation
Fair Market Value of Remodeling Work
Exterior Changes?
The work does not involve changes to the exterior
Primary Bath and Entry, Rec Room and Basement
$3,000
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