BLD2022-1365+Application+10.6.2022_11.53.01_PM+3151759CITY OF EDMONDS
Building Application #1211850 - kitchen 2022
Applicant
First Name Last Name
Charles Shifren
Number Street Apartment or Suite Nur
9715 241 st Place SW
City State Zip
Edmonds WA 98020
Contractor
Company Name
A & D CONSTRUCTION SRVCS INC
Number Street
14838 JAKE DR SE
City State Zip
MONROE WA 98272
State License Number License Expiration Date UBI #
ADCONCS936BU 2/5/2023 602676643
Project Location
i
MyBuitdingPermit.com
Company Name
ar E-mail Address
cishifren(@_gmail.com
Phone Number Extension
(206) 542-8531
Apartment or Suite Number
Phone Number Extension
2069490549
E-mail Address
daniel(aD_a-dconstruction.com
Number Street Floor Number Suite or Room Number
9715 241 ST PL SW
City Zip Code County Parcel Number
EDMONDS 98020 00450200000100
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
Charles & Lisa F Shifren & Geiger
Number Street Apartment or Suite Number
9715 241 st PI SW
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: 10/6/2022 Submitted By: Charles Shifren
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CITY OF EDMONDS MyBuildingPermit.com
Building Application #1211850 - kitchen 2022
Project Contact
Company Name:
Name: Charles Shifren Email: cjshifren@gmail.com
Address: 9715 241st Place SW Phone #: (206) 542-8531
Edmonds WA 98020
Project Type Activity Type Scope of Work
Single Family Residential Remodel Residence
Project Name: kitchen 2022
Description of replace window, relocate entry by 36 on exact same east wall provide new insulation,
Work: drywall, mechanical ventilation for induction stove for fan 399 CFM, plumbing & electrical
to code, flooring, appliances.
Project Details
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, Kitchen,
Master Bath, Garage)
Valuation
Fair Market Value of Remodeling Work $9,000
Exterior Changes?
The work does not involve changes to the exterior
Contact Information
Owner Email Address cjshifren@gmail.com
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