BLD2023-0562+Application+5.8.2023_7.24.52_PM+3485085CITY OF EDMONDS MyBuilaingPermit.coin
Building Application #1299598 - Crystal Falls BR Addition
Applicant
First Name Last Name Company Name
Mike Pernack Pernack Factor Architects
Number Street Apartment or Suite Number E-mail Address
50 Biq Bear PI. NW mip50design(cDgmaiI.com
City State Zip Phone Number Extension
Issaquah WA 98027 (425) 392-1611
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
9815 CHERRY ST
City Zip Code County Parcel Number
EDMONDS 98020 00475600000400
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
Tracy & Ayda Heims
Number Street Apartment or Suite Number
9815 CHERRY ST
City State Zip
EDMONDS WA 98020
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: 5/8/2023 Submitted By: Mike Pernack
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CITY OF EDMONDS M BuildingPerrnit.com
Building Application #1299598 - Crystal Falls BR Addition
Project Contact
Company Name: Pernack Factor Architects
Name: Mike Pernack Email: mjp50design@gmaii.com
Address: 50 Big Bear PI. NW Phone #: (425) 392-1611
Issaquah WA 98027
Project Type Activity Type Scope of Work
Single Family Residential Structure Addition Residence
Project Name: Crystal Falls BR Addition
Description of Work: Add 8ft x 21ft Bedroom Addition (168 sgft) to an Adult Family home.
Project Details
Increasing Building Height?
The height of the building is not increasing.
Impervious Surface
Adding/Replacing less than 2,000 square feet of hard
surface
Site Information
Critical Areas Designation has been completed for
the parcel
Clearing and Grading Information
Total cubic yards of cut and fill 9
Mechanical Included?
No mechanical work will occur during this project.
Plumbing Included?
No plumbing work will occur during this project.
Work Location
Work Description/Location (example: 1 st floor, Ist floor expansion of two Bedrooms
Master Bath, Garage)
Valuation
Fair Market Value of Construction Work $35,000
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