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BLD2022-0643+Application+5.17.2022_8.16.43_AM+2874297CITY OF EDMONDS MyBuilaingPermit.com Building Application #1143049 - Pawling Demolition Permit Applicant First Name Last Name Company Name Lee Michaelis Puget Sound Planninq, LLC Number Street Apartment or Suite Number E-mail Address P. 0. Box 65198 City State Zip Shoreline WA 98155 Contractor Company Name LEIF HELLEREN CONSTRUCTION INC Number Street PO BOX 1764 City State Zip EDMONDS WA 98020 State License Number License Expiration Date LEIFHC10380T 10/3/2023 Project Location Number Street 755 DALEY ST City Zip Code EDMONDS 98020 Associated Building Permit Number BLD2021-1667 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner tom(@_lerendesign.com Phone Number Extension 4258301046 Apartment or Suite Number Phone Number Extension (206) 533-8200 UBI # E-mail Address 601818421 steveIns 1043(cD-comcast. net County Parcel Number 00434208302500 Tenant Name Floor Number Suite or Room Number First Name Last Name or Company Name Gretchen G Pawlinq Number Street Apartment or Suite Number 755 DALEY ST 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: 5/17/2022 Submitted By: Lee Michaelis Page 1 of 2 i o CITY OF EDMONDS MyBuildingPerrnit.cm „c Building Application #1143049 - Pawling Demolition Permit Project Contact Company Name: Puget Sound Planning, LLC Name: Lee Michaelis Email: lee.michaelis@pugetsoundplanning.com Address: P. O. Box 65198 Phone #: 4258301046 Shoreline WA 98155 Project Type Activity Type Scope of Work Single Family Residential Demolition Primary Residence Project Name: Pawling Demolition Permit Description of Work: Demolition of a 2,640 square foot single family residence. Project Details Demolition Information Number of dwelling units to be demolished 1 Number of structures to be demolished. 1 Square feet to be demolished. 2,640 The year the structure was built. 1958 Page 2 of 2