ENG2024-0125+Application+3.22.2024_2.59.53_PM+4152302CITY OF EDMONDS MyBuildingPermit.com
Right -of -Way Application #1450160 - Fulkerson
Applicant
First Name Last Name Company Name
Austin Anderson Villaqe Life
Number Street Apartment or Suite Number E-mail Address
19020 33rd Ave W 450 austin(cD_village-life.net
City State Zip Phone Number Extension
Lynnwood WA 98036 (425) 678-1465
Contractor
Company Name
SIGNATURE HMS BY VILL LIFE LLC
Number Street Apartment or Suite Number
19020 33RD AVE W STE 450
City State Zip Phone Number Extension
LYNNWOOD WA 98036 (425) 778-4111
State License Number License Expiration Date UBI # E-mail Address
SIGNAHV788NC 8/2/2024 602977522 austin(aD_villagedife.net
Project Location
Number Street
8503 200TH ST SW
City Zip Code
EDMONDS 98026
Associated Building Permit Number
BLD2023-1355
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
First Name
Floor Number Suite or Room Number
County Parcel Number
27041900202900
Tenant 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: 3/22/2024 Submitted By: Austin Anderson
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CITY OF EDMONDS MyBuildingPermit.com
Right -of -Way Application #1450160 - 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 Activity Type Scope of Work
Single Family Residential New Excavation and Utility Work
Project Name: Fulkerson
Description of Work: Obtaining ROW permit for work in ROW associated with BLD2023-1355
Project Details
Project Information
Driveway Access
Storm Drainage Tie -In
Utility Service Installation
Impervious Surface
Adding/Replacing less than 2,000 square feet of hard
surface
Clearing and Grading Information
This is redevelopment
Tree Removal
There are five or less significant trees to be removed
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