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ENG2022-0148+Application+4.7.2022_4.03.28_PM+2789525CITY OF EDMONDS nn BtaildingPermit.com Utilities Application #1121244 - Burdett - Sunset House - SIDE SEWER PERMIT Applicant First Name Last Name Company Name Blake Fisher Blake Fisher Architecture & Design LLC Number Street Apartment or Suite Number E-mail Address 406 MAIN STREET Suite 106 blake(L-D_blakefisherarchitecture.com City State Zip Phone Number Extension Edmonds WA 98020 2068525054 Contractor Company Name RON COLWILL CONSTRUCTION INC Number Street Apartment or Suite Number 22224 98th Ave West City State Zip Phone Number Extension EDMONDS WA 98020 (206)795-3784 State License Number License Expiration Date UBI # E-mail Address RONCOCC815JS 4/10/2023 604424301 ronwcolwill@gmail.com Project Location Number Street Floor Number Suite or Room Number City Zip Code County Parcel Number Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions). Work Location NW CORNER OF ALLEY WHERE IT DEAD ENDS INTO 332 SUNSET AVE. N. PROPERTY Property Owner First Name Last Name or Company Name Number Street Apartment or Suite Number City State Zip 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: 4/7/2022 Submitted By: Blake Fisher Page 1 of 2 i CITY OF EDMONDS MyBui[di ngPerrnit.com ,.,I,,.. Utilities Application #1121244 - Burdett - Sunset House - SIDE SEWER PERMIT Project Contact Company Name: Blake Fisher Architecture & Design LLC Name: Blake Fisher Email: blake@blakefisherarchitecture.com Address: 406 MAIN STREET Suite 106 Phone #: 2068525054 Edmonds WA 98020 Project Type Activity Type Scope of Work Single Family Residential New Side Sewer Connection Project Name: Burdett - Sunset House - SIDE SEWER PERMIT Description of Work: INSTALLING SIDE SEWER Project Details Project Information Connection to City sewer service Page 2 of 2