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BLD2020-1033+Application+10.1.2020_12.58.14_PMCITY OF EDMONDS MyBuildingPermit.com Building Application #866852 - Helleren Lot 1 Building Permit Applicant First Name Last Name Company Name Leif Helleren Leif Helleren Construction, Inc. Number Street Apartment or Suite Number E-mail Address P.O. Box 1764 City State Zip Edmonds WA 98020 Contractor Company Name LEIF HELLEREN CONSTRUCTION INC Number Street PO BOX 1764 lee.michaelis@pugetsoundplanninq.com Phone Number Extension (206) 533-8200 Apartment or Suite Number City State Zip Phone Number Extension EDMONDS WA 98020 2065338200 State License Number License Expiration Date UBI # E-mail Address LEIFHC10380T 10/3/2021 601818421 lee. michaelis(cbpugetsouInd plan ninq.com Project Location Number Street Floor Number Suite or Room Number 10727 226TH ST SW City Zip Code County Parcel Number EDMONDS 98020 27032500310300 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 KariJ Johannessen Number Street Apartment or Suite Number 10727 226TH ST SW City State Zip EDMONDS WA 98020-6132 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: 10/1/2020 Submitted By: Leif Helleren Page 1 of 2 CITY OF EDMONDS M BuildingPerrnit.com Building Application #866852 - Helleren Lot 1 Building Permit Project Contact Company Name: Puget Sound Planning, LLC Name: Lee Michaelis Email: lee.a.michaelis@gmail.com Address: 5005 200th St SW Suite Phone #: 4258301046 101-B Lynnwood WA 98036 Project Type Activity Type Scope of Work Single Family Residential New Construction Residence Project Name: Helleren Lot 1 Building Permit Description of Work: Construction of a 3,126 sf single family residence and garage/shop Project Details Structure Type Single Family Dwelling Project Information Square Feet - Floor 1 153 Square Feet - Floor 2 999 Square Feet - Other 173 Square Feet - Garage 1,974 Total Dwelling Units 1 Page 2 of 2