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BLD2024-0267+Application+2.28.2024_10.14.36_AM+4088291CITY OF EDMONDS Building Application #1448821 - Fulkerson Applicant First Name Last Name Austin Anderson i MyBuitdingPermit.com Company Name Villaqe Life Number Street Apartment or Suite Number E-mail Address 19020 33rd Ave W 450 austin(L village-life.net City State Zip Lynnwood WA 98036 Contractor Company Name SIGNATURE HMS BY VILL LIFE LLC Number Street 19020 33RD AVE W City State Zip LYNNWOOD WA 98036 State License Number License Expiration Date UBI # SIGNAHV788NC 8/2/2024 602977522 Project Location Number Street 8503 200TH ST SW Phone Number Extension (425) 678-1465 Apartment or Suite Number STE 450 Phone Number Extension (425) 778-4111 E-mail Address austin(aD_villagedife.net City Zip Code County Parcel Number EDMONDS 98026 27041900202900 Associated Building Permit Number Tenant Name BLD2023-1355 Additional Information (i.e. equipment location or special instructions). Work Location Floor Number Suite or Room Number Property Owner First Name Last Name or Company Name SIGNATURE HOMES BY VILLAGE LIFE LLC Number Street Apartment or Suite Number 8503 200th ST SW City State Zip Edmonds WA 98026 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: 2/28/2024 Submitted By: Austin Anderson Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1448821 - Fulkerson Project Contact Company Name: Village Life Name: Austin Anderson Email: austin@village-life.net Address: 19020 33rd Ave W 450 Phone #: (425) 678-1465 Lynnwood WA 98036 Project Type Single Family Residential Activity Type Scope of Work Demolition Primary Residence Project Name: Fulkerson Description of Work: Demolition of existing single family house, and all surrounding structures within the property Project Details Demolition Information Number of dwelling units to be demolished 1 Number of structures to be demolished. 2 The year the structure was built. 1957 Contact Information Owner Email Address austin@village-life.net Page 2 of 2