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BLD2023-0527_Application_4.28.2023_1.00.55_PM_3512393CITY OF EDMONDS MyBuildingPermit.com Building Application #1307000 - Deck Extension Applicant First Name Last Name Company Name Dale Lane Number Street Apartment or Suite Number E-mail Address 9110 Olympic View Drive dlane1956@yahoo.com City State Zip Phone Number Extension Edmonds WA 98026 (206) 334-5022 Contractor Company Name Owner 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 9110 OLYMPIC VIEW DR City Zip Code County Parcel Number EDMONDS 98026 27041800203300 Associated Building Permit Number Tenant Name BLD2021-0580 Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Dale A Lane Number Street Apartment or Suite Number 9110 OLYMPIC VIEW DR 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: 4/28/2023 Submitted By: Dale Lane Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1307000 - Deck Extension Project Contact Company Name: Name: Dale Lane Email: dlane1956@yahoo.com Address: 9110 Olympic View Drive Phone #: (206) 334-5022 Edmonds WA 98026 Project Type Activity Type Single Family Residential Deck or Porch Project Name: Deck Extension Description of Work: Railing inspection(s) for completed deck permit #BLD2021-0580- ATTN DENISE Project Details Structure Type Deck Project Information Square Feet - Covered Deck or Porch 3 Contact Information Owner Email Address dlane1956@yahoo.com Page 2 of 2