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BLD2021-0374+Application+3.15.2021_11.59.46_AM+2086320CITY OF EDMONDS nnyst,ilaingPermit.com Building Application #933427 - GREENBUILT REFUBISHMENT Applicant First Name Last Name Company Name joe Luckey arete' Desiqn Number Street Apartment or Suite Number E-mail Address 12041 22ND AVE NE luckeyjo(�D_gmail.com City State Zip Phone Number Extension SEATTLE WA 98125 2064992814 Contractor Company Name Contractor Unknown Number Street Apartment or Suite Number City State License Number Project Location Number Street 18604 76TH AVE W City EDMONDS Associated Building Permit Number State Zip License Expiration Date Phone Number Extension UBI # E-mail Address Zip Code County Parcel Number 98026 00434600010302 Tenant Name GREENBUILT NW Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Floor Number Suite or Room Number 1 WHOLE First Name Last Name or Company Name FABIAN & STEPHANIE QUIROGA GREENBUILT NW Number Street Apartment or Suite Number 9804 LAKE CITY WAY City State Zip SEATTLE WA 98125 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: 3/15/2021 Submitted By: joe Luckey Page 1 of 2 CITY OF EDMONDS M BuildingPerrnit.cam Building Application #933427 - GREENBUILT REFUBISHMENT Project Contact Company Name: arete' Design Name: joe Luckey Email: luckeyjo@gmail.com Address: 12041 22ND AVE NE Phone #: 2064992814 SEATTLE WA 98125 Project Type Activity Type Nonresidential Remodel Project Name: GREENBUILT REFUBISHMENT Description of Work: NEW INTERIOR WALLS Project Details Project Information Square Feet -Tenant 1,440 Valuation Fair Market Value of Construction Work $16,000 Exterior Changes? The work does not involve changes to the exterior Page 2 of 2