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BLD2023-0103+Application+1.24.2023_3.45.46_PM+3329191CITY OF EDMONDS MyBuildingPermit.com Building Application #1257546 - Elliott residence addition Applicant First Name Last Name Company Name Jeremy Elliott Number Street Apartment or Suite Number E-mail Address 23422 74th Avenue West jmgn750(.@_gmail.com City State Zip Phone Number Extension Edmonds WA 98026 (206) 960-2476 Contractor Company Name Contractor Unknown Number Street Apartment or Suite Number City State Zip Phone Number Extension State License Number License Expiration Date UBI # E-mail Address Project Location Number Street Floor Number Suite or Room Number 23422 74TH AVE W City Zip Code County Parcel Number EDMONDS 98026 00488800300501 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 Jeremy Elliott Number Street Apartment or Suite Number 23422 74TH AVE W City State Zip EDMONDS WA 98026-8506 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: 1/24/2023 Submitted By: Jeremy Elliott Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Building Application #1257546 - Elliott residence addition Project Contact Company Name: Hjert-Bernardi / Architect Name: Jeri Hjert-Bernardi Email: hiert_bernardi@hotmail.com Address: 9228 39th Avenue South Phone #: (206) 632-0287 Seattle WA 98118 Project Type Activity Type Scope of Work Single Family Residential Structure Addition Residence Project Name: Elliott residence addition Description of Work: Addition of 107 sq. ft. on the basement level, 549 sq. ft. on the main level of an existing single-family residence. Project Details Increasing Building Height? The height of the building is increasing. Impervious Surface Adding/Replacing less than 2,000 square feet of hard surface Site Information There are no critical areas. Clearing and Grading Information Total cubic yards of cut and fill Mechanical Included? No mechanical work will occur during this project. Plumbing Included? Plumbing work will occur during this project. Work Location Work Description/Location (example: 1 st floor, Master Bath, Garage) Valuation Fair Market Value of Construction Work 81.7 Basement and main level addition on to an existing single-family residence $300,000 Page 2 of 2