ENG2024-0111+Application+3.15.2024_2.42.54_PM+4138752CITY OF EDMONDS MyBuildingPermit.com
Utilities Application #1459213 - Bothell Manor LLC Adult Home
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 UBI #
Number Street
1520 10TH PL N
City Zip Code County Parcel Number
EDMONDS 98020 27031300409000
Associated Building Permit Number Tenant Name
BLD2024-0257
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
Phone Number Extension
E-mail Address
Floor Number Suite or Room Number
First Name Last Name or Company Name
Dan Bockretsion BOTHELL MANOR LLC
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: 3/15/2024 Submitted By: Dan Bockretsion
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CITY OF EDMONDS MyBuildingPermit.com
Utilities Application #1459213 - Bothell Manor LLC Adult Home
Project Contact
Company Name: Point Of Vision
Name: Bob Bozorth
Address: 1628 46TH ST SE
EVERETT WA 98203
Project Type
Single Family Residential
Email: PointOfVision@Hotmail.Com
Phone #: (425) 772-8207
Activity Type
Utility Availability
Project Name: Bothell Manor LLC Adult Home
Description of Work: New SFR Adult Family Home
Project Details
Structure Type
Single Family Dwelling
Project Information
Connection to City water service
Scope of Work
Water Main
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