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BLD2023-1355+Application+10.26.2023_10.49.08_AM+3862986CITY OF EDMONDS Building Application #1394131 - Fulkerson Applicant First Name Last Name Austin Anderson i MyBuitdingPermit.com Company Name Siqnature Homes by Villaqe Life LLC Number Street Apartment or Suite Number E-mail Address 19020 33rd Ave W 450 austin(LD_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(a-)_villagedife.net Project Location Number Street 8503 200TH ST SW City Zip Code EDMONDS 98026 Associated Building Permit Number 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 19020 33RD AVE W 450 City State Zip LYNNWOOD WA 98036 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: 10/26/2023 Submitted By: Austin Anderson Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1394131 - Fulkerson Project Contact Company Name: LC ature Homes by 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 Construction Residence Project Name: Fulkerson Description of Work: construct new 3874 sqft house, demo existing home on site. Project Details Structure Type Single Family Dwelling Project Information Square Feet - Floor 1 Square Feet - Floor 2 Total Bedrooms Square Feet - Garage Total Bathrooms Total Dwelling Units Critical Area Information None Contact Information Owner Email Address 1,801 2,073 5 792 4 1 austin@village-life.net Page 2 of 2