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BLD2023-0626+Application+5.23.2023_8.43.22_AM+3529139CITY OF EDMONDS nnyst,ilaingPermit.com Building Application #1304233 - 9118 Main Fence Applicant First Name Last Name Company Name patrick claussen Number Street Apartment or Suite Number E-mail Address 9118 Main St pclaussen911(@gmail.com City State Zip Phone Number Extension Edmonds WA 98026 (425) 223-1911 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 9118 MAIN ST City Zip Code County Parcel Number EDMONDS 98026 00373600500716 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 Patrick Claussen Number Street Apartment or Suite Number 9118 MAIN ST City State Zip EDMONDS WA 98026-6934 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: 5/23/2023 Submitted By: patrick claussen Page 1 of 2 i CITY OF EDMONDS MyBui[di ngPerrnit.com Building Application #1304233 - 9118 Main Fence Project Contact Company Name: Name: Address: patrick claussen 9118 Main St Edmonds WA 98026 Project Type Single Family Residential Email: pclaussen911@gmail.com Phone #: (425) 223-1911 Activity Type Scope of Work None Fence Project Name: 9118 Main Fence Description of Work: We are gong to install a fence in our backyard. Project Details Work Location Work Description/Location (example: 1st floor, Backyard Master Bath, Garage) Contact Information Owner Email Address pclaussen911 @gmail.com Page 2 of 2