BLD2020-0733+City_Application+7.15.2020_12.27.43_PM (2)BUILD
DN
Development Services
Building Division
121 Sth Ave N / Edmonds, WA 98020
425.771.0220
For NUquirements, permit status and inspection
sche I11 c 1$-0 to: www.edmondswa.gov.
PLEASE NOTE: Intake appointments are required for New Single Family
Residences, Large Additions, ADU's, New Commercial, and Major Tenant
Improvement application submittals. If plans are prepared by a profession -al,
electronic files are requested in addition to the hard copies. Please bring
electronic files on a flash drive or coordinate for electronic transfer.
Please caA425-771-0220 to schedule an intake appointment!
JOB SITE INFORMATION/LOCATION: (Whera the work is taking place)
Job Site Address: 8120 Talbot Rd. Edmonds WA 98026
Parcel
Lot /Unit/Suite #: Subdivision:
PROPERTY OWNER:
Name: Meave Ellsworth & Chris Pichner
Mailing Address: 8120 Talbot Rd
City/State/zip: Edmonds WA 98026
Phone #- 253363.1045(Chris),206.930.4906 Meave
Email:chris ichner ahoo.cam meave.ellswordi ail.com
OWNER INSTALLATION: *If yes, read and sign*
Will work be performed by the property owner? X Yes ❑ No
I own, reside in, or will reside in the completed structure. This
installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange according to RCW
18.27.090.
Owner Signature:
APPLICANT / CONTACT INFORMATION:
Name of Applicant: Chris Pichner
Mailing Address: 8120 Talbot Rd
City/State/Zip: Edmonds WA 98026
Phone #: 253.363.1045
F-mall: . chrispichner@yahoo.com
GENERAL CONTRACTOR: [If different from applicant]
General Contractor: N/A
Mailing Address:
City/State/Zip:
Phone #:
E-mail:
STATE URI #:
CITY OF EDMONDS BUSINESS LICENSE #:
nifire !af: Qnly
(ProvideTYPE OF PERMIT Details on Page
❑ Accessory Structure/
❑ Addition
Detached Garage
❑ demolition
❑ Mechanical
❑ New Single Family / duplex
❑ Plumbing
❑ Fire Sprinkler
❑ Remodel
❑New Commercial/ Mixed Use
❑ Re -Roof
❑ Signs
❑ Tank
❑Tenant Improvement
x Other retaining wallfs)
Remodel Permit fees ore based on:
The value of the work performed. Indicate the value (rounded to
the nearest dollar) of all equipment, materials, labor, overhead,
and the profit for the work indicated on this application.
Valuation:
PROPOSED NEW SQUAREFOOTAGE a• THIS APPLICATION
Basement sq ft: Finished ❑ Unfinished ❑
1st Floor, sq ft:
2nd Floor, sq ft:
Garage/Carport:, sq it:
Deck/Covered Porch/Patio:
other sq ft:
PROJECTDESCRIPTION
��A� Zaa►.s�5c,u� ysa•tax5
31,4
4 See
I certify that the information I have provided on this form)applicatlon is true,
correct and complete, and that I am the property owner or duly authorized
agent of the property owner to submit a permit application to the City of
Edmonds.
Print Name: ii9_ 04;t]
Signa Date/f
i
rA
y1p zUT8 dp zUTB
tiq 91i3 \088loobtu0 finU J\A
n9v0\98nsA\9vnt2 191io8
19t69H lw6W l9ra
❑9d10 h92n1\9961gsiH
:19dt0 9osmW
yF YID
sbix0 zumiiN 9bix60 nodes]
re8yz0 muil9H
asdi0 1iA].Ib.M
19d10 muu96V 169181o2-IMIb9M
:09dzilom9b ed of 9tubm1210 NYT
:b9dzilom9b 9d of 9l=M to 9861001916up2
:a 9z6] AAJ29 N \ Y 59nob Y9viu2 Afl3HA
motlwim19190 2691A lmailJ
❑ isvlsW O iovisW I6noYtibno9 ❑ bmiupsA ybm2
:1611916M IR ❑93siq n11113
(2noll6t]) dnsTto 9Si2 ❑I6mm9A
:noll6nlm19190 2691A 16JI1113
❑l9vlsW ❑ 19vi6W 6nolTlbno3 ❑b9liup9A ybW2
••
zblsY 9iduo lu]:8nibma
2bisyalduo
Xo11 ❑29Y :691AI69IlnDnl Ilia\luJ
.is9y t to mumixsm 6 iot bilsv 9is 2noiMilggA :2N01TAJIJ99A
.easy S,znotlsiIggA AH e3
b9znsoil 9d of b9iiupm sib ziobmfnooduz bns zmbsifnoo HA:0NI2N3JU
6 wad bn6 29111211bn1 A lod6J to 1n9m116g90 91612 nolanld26W fbiw
.9zn9DU M.MZuB 2bnomb3 to OD 1n9iwo
:(z)bsoJ lnsqun0 :(z)quoi0 y3nsqu330
❑ oN ❑ 2sY :2isbiniig291R :noibmlznoJ to (z)sgyT
,9gol9vn9 9nibliud 901 zb9ffs bolmq iuoY t1:300J Y0A3N3 3TAT2 AW
9d19191gMO3 hum uoy ,Bnlldvl io\bn6,2m91zyz I69imd99m
.2mlot 332W 916ilgolgq6
ziiupsi HIM 16dl zfimisq 8nibliud Isim9mmo9 IIA:2JATTIMBU2 03AM930
mis16 gill io\bn6 ,i9Illnngz giit,1691nsd99m ,gnidmulq b91619WZ6
.Y19imsgs210f b911gg69 s 2 i6 sq
199ddiow TJA9MI ]I99AAT obulonI :UaJB W314 \ 32U 90 33AAH0 \ IT
•l
M i9d10\3913\2s0 aUTB
lo2zmgmoO\ tinU ]\A
VAV\ i9lbnsH VA
191108
bua l9Y a
znsl lamfl 3
9J6Ig9113
93sm W
tinU gmuq 169H
8nilssH sinmbyH
-sysb 9bivm9) fM goTtoofl
(gbla Isin9mmoJ sti znaa
19d1a
Yto Wfl
219wod2\duT lgHz6W29df.I]
(SVA,Aa]a ,AagN) 9oiv9a wo1H19se 19d26Wd21a
9vlsV lolslu89A\noibubsfl mu22si9 ni6lnuo98niAnila
ylgqu2 iWsW lolm98i1f9A Ani2\m6l0laoH
:'I io Y Yugbin6T-19169H 1916W 2d1892oH
snit9 Ms2l91sW 1ssH oinmbylA
:19di0 2M2
:19d10 091ioT