BLD2023-1013+Application+8.9.2023_8.33.13_PM+3716049CITY OF EDMONDS nnyst,ilaingPermit.com
Building Application #1360068 - AFH 2O23
Applicant
First Name Last Name Company Name
zena biru
Number Street Apartment or Suite Number E-mail Address
19615 88th Ave W
City State Zip
Edmonds WA 98026
Contractor
Company Name
Owner
Number Street
aceseniorcarehome(D_gmail.com
Phone Number Extension
(206) 405-0044
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
8419 192ND ST SW
City Zip Code County Parcel Number
EDMONDS 98026 00434600002105
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
Zena Biru
Number Street Apartment or Suite Number
19615 88TH AVE W
City State Zip
EDMONDS WA 98026
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: 8/9/2023 Submitted By: zena biru
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CITY OF EDMONDS MyBui[di ngPerrnit.com
Building Application #1360068 - AFH 2O23
Project Contact
Company Name:
Name:
Address:
zena biru
19615 88th Ave W
Edmonds WA 98026
Project Type
Single Family Residential
Email: acecarehomesLLC@gmail.com
Phone #: (206) 405-0044
Activity Type
Adult Family Home Inspection Only
Project Name: AFH 2O23
Description of Work: Get a WABO inspection required for an AFH application.
Project Details
Project Information
Number of Caretaker Bedrooms
Number of Client Bedrooms
Contact Information
Owner Email Address
1
3
AceCareHomesLLC@gmail.com
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