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BLD2023-0043+Application+1.11.2023_12.08.27_PM+3309166CITY OF EDMONDS MyBuildingPermit.com IF Building Application #1252545 - Moll Residence - Phase II Applicant First Name Last Name Company Name Brian Moll SCBC Enqineerinq, PLLC Number Street Apartment or Suite Number E-mail Address 543 Main St. 106 brian.moll.se(@gmail.com City State Zip Phone Number Extension EDMONDS WA 98020 (206) 351-2217 Contractor Company Name Contractor Unknown Number Street City State License Number Project Location State Zip License Expiration Date UBI # Number Street 16121 N MEADOWDALE RD City Zip Code County Parcel Number EDMONDS 98026 00513100004901 Associated Building Permit Number Tenant Name 19990253,20000783 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Apartment or Suite Number Phone Number Extension E-mail Address Floor Number Suite or Room Number First Name Last Name or Company Name Brian E Moll Number Street Apartment or Suite Number 16121 N MEADOWDALE RD City State Zip EDMONDS WA 98026-4547 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: 1/11/2023 Submitted By: Brian Moll Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Building Application #1252545 - Moll Residence - Phase II Project Contact Company Name: SCBC Engineering, PLLC Name: Brian Moll Email: brian.moll.se@gmail.com Address: 543 Main St. 106 Phone #: (206) 351-2217 EDMONDS WA 98020 Project Type Activity Type Scope of Work Single Family Residential Structure Addition Residence Project Name: Moll Residence - Phase II Description of Approx 300SF addition to existing residence which was constructed in 1999-2000. The Work: slab on grade and foundations for this addition were placed at the time of the original construction so are existing. 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 Critical Areas Designation has been completed for the parcel Clearing and Grading Information Total cubic yards of cut and fill 0 Mechanical Included? Mechanical work will occur during this project. Plumbing Included? No plumbing work will occur during this project. Work Location Approx 300SF living room/home office addition to Work Description/Location (example: 1st floor, residence constructed in 1999-2000. The slab on grade Master Bath, Garage) and foundations for this addition were poured with the 1999 construction. Valuation Fair Market Value of Construction Work $45,000 Page 2 of 2