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BLD2021-0175+Application+1.29.2021_3.59.55_PM+2023167CITY OF EDMONDS MyBuildingPermit.com Building Application #916425 - Koszarek residence Applicant First Name Last Name Company Name Heidi Helqeson H2D Architecture + Design Number Street Apartment or Suite Number E-mail Address 23020 Edmonds Way 113 heidi(o-)_h2darchitects.com City State Zip Phone Number Extension Edmonds WA 98020 (206) 542-3734 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 17916 73RD AVE W City Zip Code County Parcel Number EDMONDS 98026 00473700003800 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 Lauren & Simmons Christopher Koszarek Number Street Apartment or Suite Number 17916 73RD AVE 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: 1/29/2021 Submitted By: Heidi Helgeson Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #916425 - Koszarek residence Project Contact Company Name: H2D Architecture + Design Name: Heidi Helgeson Email: heidi@h2darchitects.com Address: 23020 Edmonds Way 113 Phone #: (206) 542-3734 Edmonds WA 98020 Project Type Activity Type Scope of Work Single Family Residential Structure Addition Residence Project Name: Koszarek residence Description of Work: kitchen remodel, addition, and new adu 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 Lot size in square feet Proposed Lot Coverage as a percentage Critical Areas Designation has been completed for the parcel Clearing and Grading Information Total cubic yards of cut and fill Mechanical Included? Mechanical work will occur during this project. Plumbing Included? 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 Beam, Column or Footing Relocation or addition of a structural beam, column, or footing Heated Space The work involves adding any new heated space 14509 23.9 RE kitchen remodel, addition and adu $175,000 Page 2 of 2