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BLD2021-1073+Application+7.30.2021_4.25.43_PM+2331932CITY OF EDMONDS nnyst,ilaingPermit.com Building Application #998344 - Rudberg Addition Applicant First Name Last Name Company Name Matt Rudberq Number Street Apartment or Suite Number E-mail Address 8421 202nd St. SW 5rudbergs(�D_gmai1.com City State Zip Phone Number Extension Edmonds WA 98026 2067944017 Contractor Company Name Owner Number Street City State License Number Project Location State Zip License Expiration Date UBI # Number Street 8421 202ND ST SW City Zip Code County Parcel Number EDMONDS 98026 27041900207500 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Apartment or Suite Number Phone Number Extension E-mail Address Floor Number Suite or Room Number First Name Last Name or Company Name Matt and Sarah Rudberg Number Street Apartment or Suite Number 8421 202nd St. SW City State Zip EDMONDS WA 98026-7349 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: 7/30/2021 Submitted By: Matt Rudberg Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #998344 - Rudberg Addition Project Contact Company Name: Name: Matt Rudberg Email: 5rudbergs@gmail.com Address: 8421 202nd St. SW Phone #: 206 794 4017 Edmonds WA 98026 Project Type Activity Type Scope of Work Single Family Residential Structure Addition Residence Project Name: Rudberg Addition Description of Single story residential addition coming off the back of our rambler. Addition will be a Work: kitchen, main bedroom, main bathroom, and office. Adding a front porch structure as well. The addition is 1208 Sqft. 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 10 Mechanical Included? Mechanical work will occur during this project. Plumbing Included? Plumbing work will occur during this project. Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) Valuation Fair Market Value of Construction Work Beam, Column or Footing No relocation or addition of a structural beam, column, or footing 1 st floor addition coming off back of rambler that includes kitchen, main bedroom and bathroom, and office. $175,000 Page 2 of 2