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BLD2024-1319+Application+10.8.2024_9.04.58_AM+4541376CITY OF EDMONDS Building Application #1556933 - 9212 Fence Applicant First Name Last Name Jorqe Quiroqa i MyBuitdingPermit.com Company Name Green Built Northwest LLC Number Street Apartment or Suite Number E-mail Address 18604 76TH AVE W City State Zip edmonds WA 98026 Contractor Company Name Green Built Northwest LLC Number Street 18604 76th ave w City State Zip edmonds WA 98026 State License Number License Expiration Date UBI # GREENBN861QE 11/5/2024 603448643 Project Location admin(a),greenbuiltnw.com Phone Number Extension (206) 274-9226 Apartment or Suite Number Phone Number Extension (206) 274-9226 E-mail Address admin(cD_greenbuiltnw.com Number Street Floor Number Suite or Room Number 9212 192ND PL SW City Zip Code County Parcel Number EDMONDS 98020 00434600005301 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 Jorqe Fabian Quiroga Number Street Apartment or Suite Number 7815 5TH AVE NE City State Zip SEATTLE WA 98115 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: 10/8/2024 Submitted By: Jorge Quiroga Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1556933 - 9212 Fence Project Contact Company Name: Green Built Northwest LLC Name: Jorge Quiroga Email: admin@greenbuiltnw.com Address: 18604 76TH AVE W Phone #: (206) 274-9226 edmonds WA 98026 Project Type Activity Type Scope of Work Single Family Residential New Construction Fence Project Name: 9212 Fence Description of Work: Fence install for east and south side of the home. 6ft cedar fence. Project Details Work Location Work Description/Location (example: 1 st floor, Master Bath, Garage) Contact Information Owner Email Address fence to be built - east side and south side of house (backyard) Sophie@greenbuiltnw.com Page 2 of 2