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BLD2024-0934+Application+7.18.2024_10.11.58_AM+4386402CITY OF EDMONDS MyBuitdingPermit.com Building Application #1516921 - Augustavo Residence - Vehicle Impact Repair Applicant First Name Last Name Company Name Chris Bacus Pacific Enqineerinq Technoloqies Number Street Apartment or Suite Number E-mail Address 2150 N. 107th St. 320 cbacus(o-)_pacengtech.com City State Zip Phone Number Extension Seattle WA 98133 (206) 281-7500 Contractor Company Name KUSTOM US INC Number Street Apartment or Suite Number 14253 169th Drive SE 503 City State Zip Phone Number Extension Monroe WA 98272 (425) 471-8139 State License Number License Expiration Date UBI # E-mail Address KUSTOU1847NQ 8/17/2024 604020885 Ricky. Den ham(o)kustom.us Project Location Number Street Floor Number Suite or Room Number 915 PINE ST City Zip Code County Parcel Number EDMONDS 98020 27032500116800 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 Edward J & Bayer Auqustavo Kim M Auqustavo Number Street Apartment or Suite Number 915 PINE ST 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: 7/18/2024 Submitted By: Chris Bacus Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1516921 - Augustavo Residence - Vehicle Impact Repair Project Contact Company Name: Pacific Engineering Technologies Name: Chris Bacus Email: cbacus@pacengtech.com Address: 2150 N. 107th St. 320 Phone #: (206) 281-7500 Seattle WA 98133 Project Type Activity Type Scope of Work Single Family Residential Remodel Residence Project Name: Augustavo Residence - Vehicle Impact Repair Description of Work: Vehicle Impact Repair to an existing Single -Family Residence Project Details 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 Remodeling Work Exterior Changes? The work involves changes to the exterior Contact Information Owner Email Address 1 st Floor Bedroom & Bath $100,000 kimmbayer@outlook.com Page 2 of 2