BLD2022-0329+Application+3.15.2022_4.48.08_PM+2739805CITY OF EDMONDS MyBuildingPermit.com
Building Application #1106578 - Moats Addition
Applicant
First Name Last Name Company Name
Jeffrey Moats
Number Street Apartment or Suite Number E-mail Address
9015 218th St SW jmoats5(@_netzero.com
City State Zip Phone Number Extension
Edmonds WA 98026 2067903800
Contractor
Company Name
Owner
Number Street
City
State License Number
Project Location
State Zip
License Expiration Date UBI #
Number Street
9015 218TH ST SW
City Zip Code
EDMONDS 98026
Associated Building Permit Number
CRA2022-0039
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
First Name
Jeffrey A
Number Street
PO BOX 1645
County Parcel Number
27043000205700
Tenant Name
Last Name or Company Name
Moats
Apartment or Suite Number
Phone Number Extension
E-mail Address
Floor Number Suite or Room Number
Apartment or Suite Number
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: 3/15/2022 Submitted By: Jeffrey Moats
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CITY OF EDMONDS MyBuildingPermit.com
Building Application #1106578 - Moats Addition
Project Contact
Company Name:
Name:
Address:
Jeffrey Moats
9015 218th St SW
Edmonds WA 98026
Project Type
Single Family Residential
Email: jmoats5@netzero.com
Phone #: 2067903800
Activity Type Scope of Work
Structure Addition Residence
Project Name: Moats Addition
Description of Work: Single story addition to single family residence, and minor kitchen revisions.
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
There are no critical areas.
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
21
Addition off of NE side, minor kitchen changes.
$35,130
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