BLD2024-1136+Application+8.29.2024_10.01.57_AM+4470233CITY OF EDMONDS MyBuildingPermit.com
Building Application #1539878 - Bothell Manor LLC Adult Home Demo
Applicant
First Name Last Name Company Name
Dan Bockretsion Bothell Manor LLC
Number Street Apartment or Suite Number E-mail Address
22422 97TH AVENUE W bpmafhllc(c,gmail.com
City State Zip Phone Number Extension
EDMONDS WA 98020 (425) 669-4882
Contractor
Company Name
Contractor Unknown
Number Street Apartment or Suite Number
City
State License Number
Project Location
State Zip
License Expiration Date
Number Street
1520 10TH PL N
City Zip Code
EDMONDS 98020
Associated Building Permit Number
BLD2024-0257
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
First Name
Phone Number Extension
UBI # E-mail Address
County Parcel Number
27031300409000
Tenant Name
Last Name or Company Name
BOTHELL MANOR LLC
Floor Number
Suite or Room Number
Number Street Apartment or Suite Number
22422 97TH AVE W
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: 8/29/2024 Submitted By: Dan Bockretsion
Page 1 of 2
i
CITY OF EDMONDS MyBuildingPermit.com
Building Application #1539878 - Bothell Manor LLC Adult Home Demo
Project Contact
Company Name: Bothell Manor LLC
Name: Dan Bockretsion Email: bpmafhllc@gmail.com
Address: 22422 97TH AVENUE W Phone #: (425) 669-4882
EDMONDS WA 98020
Project Type
Single Family Residential
Activity Type Scope of Work
Demolition Primary Residence
Project Name: Bothell Manor LLC Adult Home Demo
Description of Work: Demolition Existing Residence
Project Details
Demolition Information
Number of dwelling units to be demolished
Number of structures to be demolished.
Square feet to be demolished.
The year the structure was built.
Contact Information
Owner Email Address
1
1
1,604
1916
danielbockretsion@gmail.com
Page 2 of 2