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BLD2021-0873+Application+6.23.2021_10.35.40_AM+2265250CITY OF EDMONDS nnysuilaingPermit.com Building Application #979097 - McCallum 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 Apartment or Suite Number City State Zip Phone Number Extension State License Number License Expiration Date UBI # E-mail Address Project Location Number Street Floor Number Suite or Room Number 21630 98TH AVE W City Zip Code County Parcel Number EDMONDS 98020 27032500109500 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 John McCallum Number Street Apartment or Suite Number 21630 98TH 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: 6/23/2021 Submitted By: Brianna Bliven Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #979097 - McCallum Residence Project Contact Company Name: CG Engineering Name: Brandon Lang Email: brandonl@cgengineering.com Address: 250 4th Ave S 4th Ave S Phone #: 4257788500 Edmonds WA 98020 Project Type Single Family Residential Activity Type Scope of Work Remodel Residence Project Name: McCallum Residence Description of Settlement has occurred in an existing single-family home. The settlement is limited to the Work: northwest corner and west side of the house. The northwest corner of the house will be supported on pipe piles and the existing second story deck footings will be stabilized. 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 Stabilizing northwest corner of the house and existing 2nd story deck on west side of house. $1,000 Page 2 of 2