BLD2022-0628+Application+5.12.2022_1.27.15_PM+2866339CITY OF EDMONDS MyBuilaingPermit.com
Building Application #1140020 - Lang Residence Addition
Applicant
First Name Last Name Company Name
tuvia poliskin T2 Design+Architecture
Number Street Apartment or Suite Number E-mail Address
14722 32nd Ave NE t(�D_tuviapoliskin.com
City State Zip Phone Number Extension
shoreline WA 98155 (425) 395-4861
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
19637 80TH PL W
City Zip Code County Parcel Number
EDMONDS 98026 00506400000900
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
John Wesley & Sara Lanq
Number Street Apartment or Suite Number
19637 80TH PL W
City State Zip
EDMONDS WA 98026-6404
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: 5/12/2022 Submitted By: tuvia poliskin
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CITY OF EDMONDS M BuildingPerrnit.com
Building Application #1140020 - Lang Residence Addition
Project Contact
Company Name: T2 Design+Architecture
Name: tuvia poliskin Email: t@tuviapoliskin.com
Address: 14722 32nd Ave NE Phone #: (425) 395-4861
shoreline WA 98155
Project Type Activity Type Scope of Work
Single Family Residential Structure Addition Residence
Project Name: Lang Residence Addition
Description of The proposed project consists of adding a new family room, master bedroom, bathroom with
Work: extention of existing bedroom. The kitchen will be remodeled with other interior modifications
with associated electrical, plumbing and mechanical. ther ewill be anew 30" Ht. raised deck.
Project Details
Increasing Building Height?
The height of the building is increasing.
Impervious Surface
Adding/Replacing less than 2,000 square feet of hard
surface
Site Information
There are no critical areas.
Clearing and Grading Information
Total cubic yards of cut and fill 0
Mechanical Included?
Mechanical work will occur during this project.
Plumbing Included?
Plumbing work will occur during this project.
Work Location
the proposaed project consists of adding a New Family
room, Master Bedroom with Bathroom with extension of
Work Description/Location (example: 1st floor, Existing Bedrooms. Remodel of Exisitng Bathroom,
Master Bath, Garage) kitchen with interior modifications with associated
electrical, plumbing and mechanical. there will be a
New 30" Raised Deck in backyard
Valuation
Fair Market Value of Construction Work $300,000
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