BLD2023-1057_Application_8.24.2023_10.28.34_AM_3741185CITY OF EDMONDS MyBuildingPermit.com
Building Application #1366135 - 9212 Edmonds remodel
Applicant
First Name Last Name Company Name
Jorge Quiroga Green Built NW
Number Street Apartment or Suite Number E-mail Address
18604 76th ave west Ste 201 fabian@greenbuiltnw.com
City State Zip Phone Number Extension
edmonds WA 98026 (206) 274-9226
Contractor
Company Name
Green Built Northwest LLC
Number Street Apartment or Suite Number
18604 76th ave west B
City State Zip Phone Number Extension
edmonds WA 98026 (206) 274-9226
State License Number License Expiration Date UBI # E-mail Address
GREENBN861QE 11/5/2024 F;ni44RB4.,i fabian@greenbuiltnw.com
Project Location
Number Street Floor Number Suite or Room Number
9212 192ND PL SW
City Zip Code County Parcel Number
EDMONDS 98020 00434600005301
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
Jorge Fabian Quiroga
Number Street Apartment or Suite Number
7815 5TH AVE NE
City State Zip
SEATTLE WA 98115
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: 8/24/2023 Submitted By: Jorge Quiroga
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CITY OF EDMONDS MyBuildingPermit.com
Building Application #1366135 - 9212 Edmonds remodel
Project Contact
Company Name: Green Built NW
Name: Jorge Quiroga Email: fabian@greenbuiltnw.com
Address: 18604 76th ave west Ste 201 Phone #: (206) 274-9226
edmonds WA 98026
Project Type
Single Family Residential
Project Name: 9212 Edmonds remodel
Description of Work: Denise
Project Details
Demolition Information
Square feet to be demolished.
Demolition Scope
Only the interior nonbearing walls are being
demolished.
Contact Information
Owner Email Address
Activity Type
Demolition
1,000
Scope of Work
Interior Only Demo
fabian@greenbuiltnw.com
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