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ENG2023-0473+Application+9.15.2023_2.27.26_PM+3786469CITY OF EDMONDS MyBuildingPermit.com Right -of -Way Application #1376786 - 310 Daley ROW Applicant First Name Last Name Company Name Jacob Younq Citizen Desiqn Collaborative Number Street Apartment or Suite Number E-mail Address 10 Dravus Street jyounq(aDcollaborativeco.com City State Zip Phone Number Extension Seattle WA 98109 (206) 535-7908 Contractor Company Name REFORM CONST & DEV LLC Number Street Apartment or Suite Number PO BOX 65073 City State Zip SHORELINE WA 98155 State License Number License Expiration Date REFORCD778DH 3/17/2025 Project Location Number Street 310 DALEY ST City Zip Code EDMONDS 98020 Associated Building Permit Number BLD2022-1329&PLN2 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Phone Number Extension (503) 828-4279 UBI # E-mail Address 605020976 chad(a�_reformconstructiondevelopment.co County Parcel Number 00434202600101 Tenant Name Vacant Floor Number Suite or Room Number First Name Last Name or Company Name Auqustus J Bukowski Number Street Apartment or Suite Number 1516 9TH AVE N 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: 9/15/2023 Submitted By: Jacob Young Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Right -of -Way Application #1376786 - 310 Daley ROW Project Contact Company Name: Citizen Design Collaborative Name: Jacob Young Email: jyoung@collaborativeco.com Address: 10 Dravus Street Phone #: (206) 535-7908 Seattle WA 98109 Project Type Multifamily Residential Project Name: 310 Daley ROW Activity Type Scope of Work New Excavation and Utility Work Install right-of-way improvements associated with the subdivision and development of Description of adjacent private property. Right-of-way improvements include sidewalk, curb ramp, curb and Work: gutter, driveway entrances, street trees, pavement and utilities. All improvements on adjacent private property under separate permit. Project Details Project Information Driveway Access Fire Hydrant Sidewalk Improvements Storm Drainage Tie -In Utility Service Installation Impervious Surface Adding/Replacing 2,000 square feet or more of hard surface Tree Removal There are no significant trees being removed Page 2 of 2