BLD2021-1665+Application+12.8.2021_12.44.45_PM+2560478CITY OF EDMONDS nnysuilaingPermit.com
Building Application #1060634 - Brubaker Residence
Applicant
First Name Last Name Company Name
Brianna Bliven CG Engineering
Number Street Apartment or Suite Number E-mail Address
250 4th Ave S Suite 200 briannab(.@_cgengineerinq.com
City State Zip Phone Number Extension
Edmonds WA 98020 4257788500
Contractor
Company Name
Contractor Unknown
Number Street
City
State License Number
Project Location
State Zip
License Expiration Date UBI #
Number Street
9712 242ND PL SW
City Zip Code County Parcel Number
EDMONDS 98020 00450300001100
Associated Building Permit Number Tenant Name
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
Terianne Brubaker
Number Street Apartment or Suite Number
9712 242ND PL 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: 12/8/2021 Submitted By: Brianna Bliven
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CITY OF EDMONDS MyBuildingPermit.com
Building Application #1060634 - Brubaker Residence
Project Contact
Company Name: CG Engineering
Name: Morgan Kruse Email: morgank@cgengineering.com
Address: 250 4th Ave S Suite 200 Phone #: 4257788500
Edmonds WA 98020
Project Type
Single Family Residential
Activity Type Scope of Work
Remodel Residence
Project Name: Brubaker Residence
Description of Approximately 2.5 inches of settlement has occurred at the western portion of the existing
Work: home. The existing foundation will be stabilized with 2 inch diameter pipe piles driven to
refusal per the geotechnical engineering report.
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 involves changes to the exterior
Western corner of single -story house.
$65,000
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