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ENG2023-0558+ROW+Application+11.1.2023_10.57.28_AM+3874105CITY OF EDMOill MyBuitdingPermit.com IF Right -of -Way Application #1385953 - Koh - ROW permit Applicant First Name Last Name Company Name Nazim Nice Motionspace Architecture Number Street Apartment or Suite Number E-mail Address 3104 Western Avenue #107 nazim(c_motion-space.com City State Zip Phone Number Extension Seattle WA 98121 (206) 204-0490 Contractor Company Name DLHINC Number Street Apartment or Suite Number 44021 SE Tanner Rd A City State Zip Phone Number Extension North Bend WA 98045 (425) 985-2862 (360) 490-8032 State License Number License Expiration Date UBI # E-mail Address DLHIN**072B5 3/30/2024 601426869 lason(D_dlhinc.com Project Location Number Street Floor Number Suite or Room Number 15604 75TH PL W City Zip Code County Parcel Number EDMONDS 98026 00513100002410 Associated Building Permit Number Tenant Name BLD2023-0640 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name * Last Name or Company Name HARTANAH KL LLC Number Street Apartment or Suite Number 15324 MERIDIAN DR SE City State Zip LYNNWOOD WA 98087 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: 11/1/2023 Submitted By: Nazim Nice Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Right -of -Way Application #1385953 - Koh - ROW permit Project Contact Company Name: Motionspace Architecture Name: Jack Bader Email: jack@motion-space.com Address: 3104 Western Avenue #107 Phone #: (206) 495-5847 Seattle WA 98121 Project Type Activity Type Scope of Work Single Family Residential New Excavation and Utility Work Project Name: Koh - ROW permit Description of Work: work in the ROW associated with new residence under BLD2023-0640 Project Details Project Information Driveway Access Utility Service Installation Impervious Surface Adding/Replacing 2,000 square feet or more of hard surface Clearing and Grading Information This is new development Tree Removal There are no significant trees being removed Page 2 of 2