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BLD2023-0404+Application+4.3.2023_1.18.00_PM+3459666CITY OF EDMONDS nnyst,ilaingPermit.com Building Application #1292995 - Fence Applicant First Name Last Name Company Name Mike Rosen Number Street Apartment or Suite Number E-mail Address 9223 Olympic View Dr City State Zip Edmonds WA 98020 Contractor Company Name CITY WIDE FENCE CO INC Number Street 16923 48th Ave W City State Zip lynnwood WA 98037 State License Number License Expiration Date UBI # CITYWFC121 N9 10/4/2024 600643332 Project Location Number Street 9223 OLYMPIC VIEW DR rosen(c�hrpvideo.com Phone Number Extension (206) 604-7553 Apartment or Suite Number Phone Number Extension (425)745-8645 206-707-3889 E-mail Address marika(a_citywidefence.com City Zip Code County Parcel Number EDMONDS 98020 27031300103700 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Floor Number Suite or Room Number First Name Last Name or Company Name Michael J & Howard Sharon G Rosen Number Street Apartment or Suite Number 9223 OLYMPIC VIEW DR City State Zip EDMONDS WA 98020 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: 4/3/2023 Submitted By: Mike Rosen Page 1 of 2 i CITY OF EDMONDS MyBoi[di ngPerrnit.com Building Application #1292995 - Fence Project Contact Company Name: Name: Mike Rosen Email: rosen@hrpvideo.com Address: 9223 Olympic View Dr Phone #: (206) 604-7553 Edmonds WA 98020 Project Type Activity Type Single Family Residential New Construction Project Name: Fence Description of Work: Installation of a 5 foot chain link fence in back yard. Project Details Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) Contact Information Owner Email Address Scope of Work Fence This is for an outdoor back yard chain link fence. rosen@hrpvideo.com Page 2 of 2