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BLD2021-1384+Application+10.7.2021_4.16.12_PM+2451317CITY OF EDMONDS MyBuildingPermit.com Clearing and Grading Application #1031690 - Port of Edmonds Admin Building Applicant First Name Last Name Company Name Jared Underbrink CG ENGINEERING Number Street Apartment or Suite Number E-mail Address 250 4th Ave S jaredu(.@cgengineerinq.com City State Zip Phone Number Extension Edmonds WA 98020 4257788500 Contractor Company Name Contractor Unknown Number Street Apartment or Suite Number City State License Number Project Location State Zip License Expiration Date Number Street 471 ADMIRAL WAY City Zip Code EDMONDS 98020 Associated Building Permit Number 1029600 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Phone Number Extension UBI # E-mail Address County Parcel Number 27032300415800 Tenant Name Port of Edmonds Last Name or Company Name PORT OF EDMONDS Floor Number Suite or Room Number Number Street Apartment or Suite Number 336 ADMIRAL WAY City State Zip EDMONDS WA 98020 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: 10/7/2021 Submitted By: Jared Underbrink Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Clearing and Grading Application #1031690 - Port of Edmonds Admin Building Project Contact Company Name: CG ENGINEERING Name: Jared Underbrink Email: jaredu@cgengineering.com Address: 250 4th Ave S Phone #: 4257788500 Edmonds WA 98020 Project Type Activity Type Scope of Work Commercial New Clearing and Grading Project Name: Port of Edmonds Admin Building Description of Construction of a new retail, office and maintenance shop within a building footprint of Work: 6,650 sf. Exterior work includes revised curb cut, parking, landscaping, lighting, and utilities. Project Details Development Type Commercial Project Information This is a redevelopment Clearing and Grading Information Total cubic yards of cut and fill 560 Page 2 of 2