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BLD2023-1282+Application+10.13.2023_12.27.31_PM+3839039CITY OF EDMONDS MyBuildingPermit.com Building Application #1389553 - Chapin Home Addition Applicant First Name Last Name Company Name brian chapin Number Street Apartment or Suite Number E-mail Address 19311 83rd pl w brian.chapin1(@_gmail.com City State Zip Phone Number Extension edmonds WA 98026 (727) 637-3009 Contractor Company Name Owner 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 19311 83RD PL W City Zip Code County Parcel Number EDMONDS 98026 00572500001400 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 Brian R & Chapin Laura M Chapin Number Street Apartment or Suite Number 19311 83RD PL W City State Zip EDMONDS WA 98026 Certification Statement - The applicant states: 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. 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: 10/13/2023 Submitted By: brian Chapin Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Building Application #1389553 - Chapin Home Addition Project Contact Company Name: Name: Address: brian chapin 19311 83rd pl w edmonds WA 98026 Project Type Single Family Residential Email: brian.chapin1@gmail.com Phone #: (727) 637-3009 Activity Type Scope of Work Structure Addition Residence Project Name: Chapin Home Addition Description of Work: 700 sgft home addition on to the back of the house attached to the main level above a walk out basement. 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. Critical Areas Designation has been completed for the parcel Clearing and Grading Information Total cubic yards of cut and fill 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, Master Bath, Garage) Valuation Fair Market Value of Construction Work 5 addition attached to the main floor of the house above a walk out basement. $50,000 Page 2 of 2