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BLD2022-0132+Application+2.1.2022_4.31.09_PM+2655461CITY OF EDMONDS Building Application #1085866 - Sowa Applicant First Name Last Name Jason Lane Number Street Apartment or Suite Number 6404 6404 230th St SW City State Zip Mountlake Terrace WA 98043 Contractor Company Name JASON LANE INDUSTRIES INC Number Street P O BOX 344 City State Zip MOUNTLAKE WA 98043 State License Number License Expiration Date JASONLI826MR 7/19/2022 Project Location Number Street 22903 76TH AVE W City Zip Code EDMONDS 98026 Associated Building Permit Number Critical areas Additional Information (i.e. equipment location or special instructions). Work Location Property Owner i MyBuitdingPermit.com Company Name JASON LANE INDUSTRIES INC E-mail Address jaysenlane(LD_hotmail.com Phone Number Extension 2062616229 Apartment or Suite Number Phone Number Extension (206)261-6229 UBI # E-mail Address 604256776 jaysenlane(a-)_hotmail.com County Parcel Number 00441500100500 Tenant Name Floor Number Suite or Room Number First Name Last Name or Company Name Jessica & Tomkinson Emily Sowa Number Street Apartment or Suite Number 22903 76TH 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: 2/1/2022 Submitted By: Jason Lane Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1085866 - Sowa Project Contact Company Name: JASON LANE INDUSTRIES INC Name: Jason Lane Email: jaysenlane@hotmail.com Address: 6404 6404 230th St SW Phone #: 2062616229 Mountlake Terrace WA 98043 Project Type Activity Type Scope of Work Single Family Residential Structure Addition Residence Project Name: Sowa Description of Work: Addition of about 615 Sq. Ft. to the rear of the structure. Project Details Increasing Building Height? The height of the building is not increasing. Impervious Surface Adding/Replacing less than 2,000 square feet of hard surface Site Information There are no critical areas. 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 5 22903 76th Ave. West Edmonds Wa. 98026 $2,000,000 Page 2 of 2