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BLD2022-0069+Application+1.20.2022_1.13.47_PM+2593155CITY OF EDMONDS Building Application #1068101 -Kelly Remodel Applicant First Name Last Name Rebecca Kelly Number Street Apartment or Suite Number 8524 215th st SW City State Zip EDMONDS WA 98026 Contractor Company Name Haider Construction Number Street 5607 244th St. SW City State Zip Mountlake Terrace WA 98043 State License Number License Expiration Date UBI # HAIDEC*914DB 4/7/2023 602903374 Project Location Number Street 8524 215TH ST SW City Zip Code County Parcel Number EDMONDS 98026 00555400000900 Associated Building Permit Number Tenant Name 1061969 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner MyBuildingPermit.com Company Name E-mail Address beckiekelly@gmail.com Phone Number Extension 2062277780 Apartment or Suite Number Phone Number Extension 4257713515 E-mail Address beckiekelly@gmail.com Floor Number Suite or Room Number First Name Last Name or Company Name Rebecca Family Number Street Apartment or Suite Number 8524 215th 215th st SW City State Zip EDMONDS WA 98026 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: 1/20/2022 Submitted By: Rebecca Kelly Page 1 of 2 CITY OF EDMONDS Building Application #1068101 -Kelly Remodel Project Contact Company Name: Name: Rebecca Kelly Email: beckiekelly@gmail.com Address: 8524 215th st SW Phone #: 2062277780 EDMONDS WA 98026 Project Type Single Family Residential i MyBuildingPermit.com Activity Type Scope of Work Structure Addition Residence Project Name: Kelly Remodel Description of Work: addition off the back of house, bottom floor and part of the 2nd floor into our backyard Project Details Increasing Building Height? The height of the building is not increasing. Impervious Surface Adding/Replacing less than 2,000 square feet of hard surface Site Information There are no critical areas. Mechanical Included? No 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 Construction Work 1st floor kitchen and living room, 2nd floor bathrooms $319,000 Page 2 of 2