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BLD2023-0454+Application+4.12.2023_9.38.41_AM+3457872CITY OF EDMONDS nnyst,ilaingPermit.com Building Application #1292381 -Permit for Dwelling Applicant First Name Last Name Company Name Badri Samanian Number Street Apartment or Suite Number E-mail Address 22425 100th Avenue West badrisamanian(,@_hotmail.com City State Zip Phone Number Extension Edmonds WA 98020 (206) 739-9262 Contractor Company Name Owner Number Street City State License Number Project Location State Zip License Expiration Date UBI # Number Street 22425 100TH AVE W City Zip Code County Parcel Number EDMONDS 98020 00450700500013 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Apartment or Suite Number Phone Number Extension E-mail Address Floor Number Suite or Room Number First Name Last Name or Company Name Bahram & Badressadat V Samanian Number Street Apartment or Suite Number 22425 100TH AVE W City State Zip EDMONDS WA 98020-5911 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: 4/12/2023 Submitted By: Badri Samanian Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1292381 -Permit for Dwelling Project Contact Company Name: Name: Address: Badri Samanian 22425 100th ave w Edmonds WA 98020 Project Type Single Family Residential Email: badrisamanian@hotmail.com Phone #: (206) 739-9262 Project Name: Permit for Dwelling Description of Work: permit for adu Project Details Activity Type Scope of Work Remodel Accessory Dwelling Unit Accessory Dwelling Unit Information Square feet - primary dwelling unit Square Feet of the accessory dwelling unit. The floor the ADU is located in. Mechanical Included? No mechanical work will occur during this project. Plumbing Included? No plumbing work will occur during this project. Additional Project Information Fair Market Value of Remodel Work Contact Information Owner Email Address 1,032 1,014 1,014 $70,000 badrisamanian@hotmail.com Page 2 of 2