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BLD2022-1247+Application+9.16.2022_4.08.42_PM+3114125CITY OF EDMONDS nnyst,ilaingPermit.com Building Application #1202670 - Kvistad Residence Applicant First Name Last Name Company Name Neil Jorgensen J3 Architects LLC Number Street Apartment or Suite Number E-mail Address 11702 98th Ave NE 105 neil@i3dlc.com City State Zip Phone Number Extension KIRKLAND WA 98034 (206) 412-9296 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 9723 CHERRY ST City Zip Code County Parcel Number EDMONDS 98020 27031300403100 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 Cark M Kvistad Number Street Apartment or Suite Number 9723 CHERRY ST City State Zip EDMONDS WA 98020-2337 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: 9/16/2022 Submitted By: Neil Jorgensen Page 1 of 2 CITY OF EDMONDS MYBuildingPerrnit.com Building Application #1202670 - Kvistad Residence Project Contact Company Name: J3 Architects LLC Name: Neil Jorgensen Email: neil@j3-Ilc.com Address: 11702 98th Ave NE 105 Phone #: (206) 412-9296 KIRKLAND WA 98034 Project Type Single Family Residential Activity Type Scope of Work Remodel Residence Project Name: Kvistad Residence Description of Work: CONVERT EXISTING UPPER FLOOR REC ROOM TO A MASTER BEDROOM, BATHROOM AND OFFICE Project Details 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 Remodeling Work Exterior Changes? The work involves changes to the exterior Contact Information Owner Email Address CONVERT EXISTING UPPER FLOOR REC ROOM TO A MASTER BEDROOM, BATHROOM AND OFFICE $20,000 michael@kvistad.org Page 2 of 2