BLD2024-0940+PAPER APPLICATION7.18.2024_12.08.44_AM+4385517,ni I S�3_
BUILDING PERMIT
APPLICATION
Development Services
BuAdng Division
121 Sth Ave N / Edmonds, WA 98020
425.771.0220
For handouts, sabaviMf requiirmrerrts go to: rvww. edmondswo.go v.
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go to: glvw.mjrbuitdingpermit.Corn
JOB SITE INFORMATION/LOCATION: (Where the work is taking place)
Job Site Address: 19922 81 st Place West
Parcel: 00603400001700
Lot /Unit/Suite #: _17 Subdivision: Valley HI
`BUSINESS OR PROPERTY OWNER
Name: Mr Hoff
Mailing Address- 1020 Bell Street
city/statdr Edmonds, Washingoon 98026
Phone s€ 206-919-2594
Email: rhoff@ Windermere_com
OWNER INSTALLATION: *If yes, read and sign*
Witi1WDT4 beperi0rrne>3bytlnepTopertyowneT?11,fes 450
I own, reside in, or will reside in the completed structur . Thi
installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange according to RCW
18.27.090.
Owner Signature'.
APPLICANT / CONTACT INFORMATION:
Name of Applicant: Ryan Hoff
Mailing Address: 19922 81 St Place West
city/state./Zip: Edmonds. Washington 98026
Phone M. 206'919-2594
E-mail: rhoft(—Wwindermere_com
GENERAL CONTRACTOR: (If different from applicant)
General Contractor: Kelli Homes LLC
Mailing Address:1020 Bell Str
City/State/hp: Edmonds, WA
Pho -A, 425-478-6058
n-
E mail: kelli(ftellihomes.com
STATE uBl M 602 796 173
CITY OF EDMONDS BUSINESS LICENSE #: 602796173
WA STATE CONTRACTOR L & I #- (CCB) & EXPIRATION DATE
KELLIHL849PJ 10/02/2024
Accessory Structure/ Addition I
Detached Garage
Demofation j Mechanical
nNew Single Farnify/Duplex a Plumbing
Fire Sprinkler Remodel
0 New Commercial/Mixed Use IVILVJ Re -Roof
Il Signs F Tank
Tenant Improvement
❑ R1 Other
Remodel Permit fees are based orr
,he vdive of A-k-work performed- IYrdcafe the value (rounded to
ttae nearest dollar) of all eqjgzrient, materials, labor, overhead,
and the profit for the work ndc&ed on 9tais application.
Vakwft c 125,000-00
PROPOSED NEW SQUARE FOOTAGE FOR THIS APPLICATION
Basement sq ft: Finished Unfinished
1st Floor, sq ft:
516
2nd Floor, sqft:
0
Garage/carport., sq ft..
0
Deck/Covered Porch/Patio:
199
# of NEW Bedrooms: 0
PROJECTDESCRIPTION
# of NEW Bathrooms: 1
I certify that the information I have provided on th6 form/application is true,
correct and complete, and that I am the property owner or duly authorized
agent of the property owner to submit a perrnR application to the City of
Edmonds -
Print Name: Raquel Gaenz 1
Signatu
I