ENG2023-0436+Application+8.24.2023_9.59.02_AM+3744842CITY OF EDMONDS
Right -of -Way Application #1367138 - SLAC
Applicant
First Name Last Name
Duane Landsverk
i
MyBuitdingPermit.com
Company Name
Landsverk Quality Homes, Inc.
Number Street Apartment or Suite Number E-mail Address
24113 56TH AVE W
City State
Zip
Mountlake Terrace WA
98043
Contractor
Company Name
LANDSVERK QUALITY HOMES INC
Number Street
24113 56th Ave W
City
State Zip
Mountlake Terrace
WA 98043
State License Number
License Expiration Date UBI #
LANDSQH023JN
4/16/2025 601855300
Project Location
Number Street
19515 94TH PL W
duane(.@_lgh-inc.com
Phone Number Extension
(425) 754-2069
Apartment or Suite Number
Phone Number Extension
(425) 754-2069
E-mail Address
duane(cDlgh-inc.com
City Zip Code County Parcel Number
EDMONDS 98020 00434600005801
Associated Building Permit Number Tenant Name
BLD2023-0623
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
Floor Number Suite or Room Number
First Name Last Name or Company Name
Duane Landsverk
Number Street Apartment or Suite Number
24113 56TH AVE W
City State Zip
Mountlake Terrace WA 98043
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: 8/24/2023 Submitted By: Duane Landsverk
Page 1 of 2
i
CITY OF EDMONDS MyBuildingPermit.com
Right -of -Way Application #1367138 - SLAC
Project Contact
Company Name: Landsverk Quality Homes, Inc.
Name: Duane Landsverk Email: duane@lqh-inc.com
Address: 24113 56TH AVE W Phone #: (425) 754-2069
Mountlake Terrace WA 98043
Project Type Activity Type Scope of Work
Single Family Residential New Excavation and Utility Work
Project Name: SLAC
Description of Work: Sewer Line
Project Details
Project Information
Utility Service Installation
Impervious Surface
Adding/Replacing less than 2,000 square feet of hard
surface
Clearing and Grading Information
This is neither new development nor redevelopment.
Tree Removal
There are no significant trees being removed
Page 2 of 2