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ENG2022-0045+Application+2.4.2022_9.49.41_AM+2661779-1; CITY OF EDMONDS MyBuildingPermit.com Right -of -Way Application #1087479 - John Trang new construction Applicant First Name Last Name Company Name JOHN TRANG Number Street Apartment or Suite Number E-mail Address 14534 27th AVE NE. johntrang2012@yahoo.com City State Zip Phone Number Extension SHORELINE WA 98155 2062271031 Contractor Company Name T & D GENERAL CONSTR & PAINTNG Number Street Apartment or Suite Number 14534 27th Ave NE City State Zip Phone Number Extension SHORELINE WA 98155 2062271031 State License Number License Expiration Date UBI # E-mail Address TDGENDG923KT 10/14/2022 602836204 Iohntrang2012(a)_yahoo.com Project Location Number Street City Zip Code County Parcel Number Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions). Work Location 23129 74th Ave W EDMONDS, WA 98026 Property Owner First Name Last Name or Company Name Floor Number Suite or Room Number Number Street Apartment or Suite Number City State Zip 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: 2/4/2022 Submitted By: JOHN TRANG Page 1 of 2 i -1; CITY OF EDMONDS MyBuildingPermit.com Right -of -Way Application #1087479 - John Trang new construction Project Contact Company Name: Name: JOHN TRANG Email: johntrang2012@yahoo.corn Address: 14534 27th AVE NE. Phone #: 2062271031 SHORELINE WA 98155 Project Type Activity Type Scope of Work Single Family Residential New Excavation and Utility Work Project Name: John Trang new construction Description of Install construction entrance per detail on sheet C2, CIVIL plan. Using standard form from Work: city Edmonds. Any work related electrical or utility belong to TRANG Short Plat, 23135 75th PI W. Edmonds, WA 98026 Project Details Project Information Driveway Access Impervious Surface Adding/Replacing 2,000 square feet or more of hard surface Clearing and Grading Information This is new development Tree Removal There are no significant trees being removed Page 2 of 2