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ENG2023-0338+Application+7.9.2023_5.48.36_PM+3654838CITY OF EDMONDS MyBuildingPermit.com Utilities Application #1344215 - lacolucci Home - 1005 Cascade Drive Applicant First Name Last Name Company Name Keith lacolucci Number Street Apartment or Suite Number E-mail Address 1005 Cascade Drive keith.iacolucci(cbgmail.com City State Zip Phone Number Extension Edmonds WA 98020 (206) 890-4096 Contractor Company Name Owner Number Street Apartment or Suite Number City State License Number Project Location State Zip License Expiration Date UBI # Number Street 1005 CASCADE DR City Zip Code County Parcel Number EDMONDS 98020 00592800000100 Associated Building Permit Number Tenant Name BLD2023-0600 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Phone Number Extension E-mail Address Floor Number Suite or Room Number First Name Last Name or Company Name Aaron K & Andrea N Loukes lacolucci Number Street Apartment or Suite Number 1005 Cascade Drive 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: 7/9/2023 Submitted By: Keith lacolucci Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Utilities Application #1344215 - lacolucci Home - 1005 Cascade Drive Project Contact Company Name: Name: Keith lacolucci Email: keith.iacolucci@gmail.com Address: 1005 Cascade Drive Phone #: (206) 890-4096 Edmonds WA 98020 Project Type Activity Type Scope of Work Single Family Residential Utility Modification Partial Line Replacement Project Name: lacolucci Home - 1005 Cascade Drive Description of Work: Residential home remodel. lacolucci 1005 Cascade Drive Project Details Structure Type Single Family Dwelling Project Information Relocate Page 2 of 2