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ENG2024-0540+Application+11.25.2024_10.47.02_AM+4637458CITY OF EDMONDS MyBuildingPermit.com Utilities Application #1582461 - Hoff - Addition/Remodel/Deck Applicant First Name Last Name Company Name Arne Gaenz Kelli Homes Number Street Apartment or Suite Number E-mail Address 1020 Bell St arne(cDkellihomes.com City State Zip Phone Number Extension Edmonds WA 98020 (425) 478-6057 Contractor Company Name KELLI HOMES LLC Number Street Apartment or Suite Number 1020 Bell ST City State Zip EDMONDS WA 98020 State License Number License Expiration Date KELLIHL849PJ 12/2/2024 Project Location Number Street 19922 81 ST PL W City Zip Code EDMONDS 98026 Associated Building Permit Number BLD2024-0940 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Phone Number Extension (425) 478-6057 UBI # E-mail Address 602796173 arne(aD_kellihomes.com County Parcel Number 00603400001700 Tenant Name Floor Number Suite or Room Number First Name Last Name or Company Name Ryan & Hoff Cassie Hoff Number Street Apartment or Suite Number 210 5TH AVE S 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: 11/25/2024 Submitted By: Arne Gaenz Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Utilities Application #1582461 - Hoff - Addition/Remodel/Deck Project Contact Company Name: Kelli Homes Name: Arne Gaenz Email: arne@kellihomes.com Address: 1020 Bell St Phone #: (425) 478-6057 Edmonds WA 98020 Project Type Activity Type Scope of Work Single Family Residential Utility Modification Partial Line Replacement Project Name: Hoff -Add ition/Remodel/Deck Description of Work: Add a cleanout as described on the building site plans and required by the City of Edmonds during the permitting process. Project Details Structure Type Single Family Dwelling Project Information Replace Page 2 of 2