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BLD2022-1409+Application+10.16.2022_5.46.07_PM+3167103CITY OF EDMONDS nnyst,ilaingPermit.com Building Application #1216600 - 23619 104th Ave W Applicant First Name Last Name Company Name Gina Weyant UNTITLED LABS INC DBA MADE Number Street Apartment or Suite Number E-mail Address 701 Sutter st Floor 3 gina@maderenovation.com City State Zip Phone Number Extension San Francisco CA 94109 (415) 589-1655 Contractor Company Name A&O GENERAL CONSTRUCTION LLC Number Street Apartment or Suite Number 15703 3RD AVE NE City State Zip Phone Number Extension SHORELINE WA 98155 (206)475-8408 4155891655 State License Number License Expiration Date UBI # E-mail Address OGENEGC793QC 11/3/2023 604822552 aoqeneralconstructionsllc@gmail.com Project Location Number Street Floor Number Suite or Room Number 23619 104TH AVE W City Zip Code County Parcel Number EDMONDS 98020 27033600302100 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 Matt & Sarah Baldock Number Street Apartment or Suite Number 23619 104TH AVE 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: 10/16/2022 Submitted By: Gina Weyant Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1216600 - 23619 104th Ave W Project Contact Company Name: UNTITLED LABS INC DBA MADE RENOVATION Name: Gina Weyant Email: gina@maderenovation.com Address: 701 Sutter st Floor 3 Phone #: (415) 589-1655 San Francisco CA 94109 Project Type Single Family Residential Activity Type Scope of Work Remodel Residence Project Name: 23619 104th Ave W Description of 49 Sq Ft Bathroom Remodel on Ground Floor. In -Kind. No Structural. No Changes to Walls, Work: Openings, or Layout Replace Existing with (N) Curbed Shower, Toilet/Bidet, and Vanity. All (N) Fixtures, Finishes, Lights, Switches, Outlets, and Exhaust Fan Project Details Mechanical Included? Mechanical work will occur during this project. Plumbing Included? 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 does not involve changes to the exterior Contact Information Owner Email Address Main Bathroom on Ground Floor $6,500 sarahjbaldock@gmail.com Page 2 of 2