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BLD2021-1686+Application+12.14.2021_10.47.13_AM+2571154CITY OF EDMONDS nnysuilaingPermit.com Building Application #1064178 - 7918 203rd Demo Applicant First Name Last Name Company Name Select Homes Select Homes Select Homes, Inc. Number Street Apartment or Suite Number E-mail Address 8304 212th Street Southwest kayla.clark(D_outlook.com City State Zip Phone Number Extension Edmonds WA 98026 4257426044 Contractor Company Name Select homes inc Number Street Apartment or Suite Number 8304 212th St SW City State Zip Phone Number Extension Edmonds WA 98026 (425) 742-6044 State License Number License Expiration Date UBI # E-mail Address SELECH1110KN 1/2/2023 601148280 kayla.clark(c_outlook.com Project Location Number Street Floor Number Suite or Room Number 7918 203RD ST SW City Zip Code County Parcel Number EDMONDS 98026 27041900112700 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 SELECT HOMES INC Number Street Apartment or Suite Number 8304 212TH ST SW 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: 12/14/2021 Submitted By: Select Homes Select Homes Page 1 of 2 i CITY OF EDMONDS MyBui[di ngPerrnit.com Building Application #1064178 - 7918 203rd Demo Project Contact Company Name: Select Homes, Inc. Name: Kayla Nichols Email: kayla.clark@outlook.com Address: 8304 212th Street Southwest Phone #: 4257426044 Edmonds WA 98026 Project Type Single Family Residential Activity Type Scope of Work Demolition Primary Residence Project Name: 7918 203rd Demo Description of Work: Demo of SFR and shed Project Details Demolition Information Number of dwelling units to be demolished 1 Number of structures to be demolished. 2 Square feet to be demolished. 1,700 The year the structure was built. 1942 This property is part of a current or future short plat or lot line adjustment. Page 2 of 2