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BLD2021-0675+Application+5.13.2021_11.03.09_PM+2174818CITY OF EDMONDS MyBuilaingPermit.com Building Application #956897 - Gross Residence Remodel Applicant First Name Last Name Company Name Erin Gross Number Street Apartment or Suite Number E-mail Address 17303 72nd Ave W erin.danae.gross@gmail.com City State Zip Phone Number Extension Edmonds WA 98026 2069498222 Contractor Company Name BELOTTI MCHUGH DSN\CNST SR LLC Number Street Apartment or Suite Number 1900 N Northlake Way Suite 249 City State Zip Phone Number Extension Seattle WA 98103 (206) 458-0570 State License Number License Expiration Date UBI # E-mail Address belotmd881cq 2/7/2022 603174362 erin.danae.gross@gmail.com Project Location Number Street Floor Number Suite or Room Number 17303 72ND AVE W City Zip Code County Parcel Number EDMONDS 98026 00513100013803 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 Mark F & Erin D Gross Number Street Apartment or Suite Number 17303 72ND AVE W City State Zip EDMONDS WA 98026 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: 5/13/2021 Submitted By: Erin Gross Page 1 of 2 CITY OF EDMONDS Mysu;laingPerrnit.com Building Application #956897 - Gross Residence Remodel Project Contact Company Name: Belotti McHugh Design and Const. Services Name: Todd McHugh Email: todd@belottimchugh.com Address: 1900 N Northlake Way Suite 249 Phone #: 206.458.0570 Seattle WA 98103 Project Type Single Family Residential Project Name: Gross Residence Remodel Activity Type Scope of Work Remodel Residence Removal and reconfiguration of first floor interior (non -bearing) walls, renovating existing Description of bedrooms, bathrooms and kitchen. Replacement of most exterior windows. Reconfiguration Work: of stair. Second floor interior wall reconfiguration of non -bearing walls. Removal of existing fireplace and chimney. Project Details 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 Remodeling Work Exterior Changes? The work involves changes to the exterior 1 st floor throughout, stair, and 2nd floor above garage $125,000 Page 2 of 2