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ENG2023-0548+ROW+Application+10.25.2023_9.36.29_AM+3860021CITY OF EDMONDS MyBuildingPermit.com Right -of -Way Application #1393831 - right of way pipes Applicant First Name Last Name Company Name Sofia Bolotin Number Street Apartment or Suite Number E-mail Address 18230 91stAve W Sofikland(aDgmail.com City State Zip Phone Number Extension Edmonds WA 98026 (425) 551-9193 Contractor Company Name SPH CONSTRUCTION INC Number Street Apartment or Suite Number 2505 92ND PL SE City State Zip Phone Number Extension EVERETT WA 98208 (425) 870-1292 State License Number License Expiration Date UBI # E-mail Address SPHCOC183ODG 4/11/2025 604091520 yura1203(ab_gmail.com Project Location Number Street Floor Number Suite or Room Number 18230 91 ST AVE W City Zip Code County Parcel Number EDMONDS 98026 27041800200300 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 Sofia & Vladimir Bolotin Number Street Apartment or Suite Number 18230 91 ST 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: 10/25/2023 Submitted By: Sofia Bolotin Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Right -of -Way Application #1393831 - right of way pipes Project Contact Company Name: Name: Address: Sofia Bolotin 18230 91 st Ave W Edmonds WA 98026 Email: Sofikland@gmail.com Phone #: (425) 551-9193 Project Type Activity Type Single Family Residential Modification Project Name: right of way pipes Description of Work: Installing new pipes in place of old ones Project Details Impervious Surface Adding/Replacing less than 2,000 square feet of hard surface Tree Removal There are no significant trees being removed Scope of Work Excavation and Utility Work Page 2 of 2