BLD2023-0329+Application+3.15.2023_12.03.19_PM+3422805CITY OF EDMONDS MyBuildingPermit.com
Building Application #1283367 - Tesfahunegn residence
Applicant
First Name Last Name Company Name
Carmelo Laviste CNL Design
Number Street Apartment or Suite Number E-mail Address
216 NE 175th street bongnl(cD_hotmail.com
City State Zip Phone Number Extension
Shoreline WA 98155 (206) 683-2395
Contractor
Company Name
Contractor Unknown
Number Street Apartment or Suite Number
City
State
Zip
Phone Number Extension
State License Number
License Expiration
Date UBI #
E-mail Address
Project Location
Number Street Floor Number Suite or Room Number
23921 76TH AVE W
City Zip Code County Parcel Number
EDMONDS 98026 00488800600803
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
Nardos B & Leakemariam T G Tesfahunegn
Number Street Apartment or Suite Number
23921 76TH AVE W
City State Zip
EDMONDS WA 98026-8811
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: 3/15/2023 Submitted By: Carmelo Laviste
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Building Application #1283367 - Tesfahunegn residence
Project Contact
Company Name: CNL Design
Name: Carmelo Laviste Email: bongnl@hotmail.com
Address: 216 NE 175th street Phone #: (206) 683-2395
Shoreline WA 98155
Project Type
Single Family Residential
Activity Type
Adult Family Home Inspection Only
Project Name: Tesfahunegn residence
Description of Work: Conversion of an existing Single -Family Residence into an Adult Family Home
Project Details
Project Information
Number of Caretaker Bedrooms 1
Number of Client Bedrooms 4
Contact Information
Owner Email Address rodasmerit@gmail.com
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