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BLD2023-1509+Application+11.22.2023_9.56.04_AM+3854398CITY OF EDMONDS MyBuildingPermit.com Building Application #1393355 - GBNW-Edmonds_Fabian_K23-013 Applicant First Name Last Name Company Name Owen Keeper KB Pro Desiqn Number Street Apartment or Suite Number E-mail Address 400 NW Gilman Blvd #171 City State Zip Issaquah WA 98027 Contractor Company Name Green Built Northwest LLC Number Street 17713 15th Ave NE, Ste 201 City State Zip SHORELINE WA 98155 State License Number License Expiration Date GREENBN861 QE 11/5/2024 Project Location Number Street 9212 192ND PL SW City Zip Code EDMONDS 98020 Associated Building Permit Number Additional Information (i.e. equipment location or special instructions). Work Location Property Owner owen(D,kbprodesign.com Phone Number Extension (425) 414-4264 Apartment or Suite Number Phone Number Extension (206) 274-9226 UBI # E-mail Address 603448643 fabian(c_greenbuiltnw.com County Parcel Number 00434600005301 Tenant Name Floor Number Suite or Room Number First Name Last Name or Company Name Jorqe Fabian Quiroqa Number Street Apartment or Suite Number 7815 5TH AVE NE City State Zip SEATTLE WA 98115 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: 11/22/2023 Submitted By: Owen Keeper Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Building Application #1393355 - GBNW-Edmonds_Fabian_K23-013 Project Contact Company Name: KB Pro Design Name: Owen Keeper Email: owen@kbprodesign.com Address: P.O. BOX #171 Phone #: (425) 414-4264 Issaquah WA 98027 Project Type Single Family Residential Activity Type Scope of Work Remodel Residence Project Name: GBNW-Edmonds_Fabian_K23-013 Remodel of the Existing Single Family residence. No new S.F. is being added per this permit. Description of The area of alteration is on both Levels of the House and the Main Alteration is Above the Work: Garage as it is being rebuild with New Roof Line Being Higher then the Existing and Previous Roof. 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, Master Bath, Garage) Valuation Fair Market Value of Remodeling Work Exterior Changes? The work involves changes to the exterior Contact Information Owner Email Address Lower Level and the Upper Level is Being Partially remodeled. $75,000 owen@kbprodesign.com Page 2 of 2