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BLD2024-0257+Application+2.26.2024_3.17.53_PM+4082654CITY OF EDMONDS MyBuildingPermit.com IF Building Application #1447279 - Bothell Manor Adult Home Applicant First Name Last Name Company Name Bob Bozorth Point of Vision Number Street Apartment or Suite Number E-mail Address 1628 46th Avenue SE PointOfVision(�DHotmail.Com City State Zip Phone Number Extension Everett WA 98203 (425) 772-8207 Contractor Company Name Contractor Unknown Number Street City State License Number Project Location State Zip License Expiration Date UBI # Number Street 1520 10TH PL N City Zip Code EDMONDS 98020 Associated Building Permit Number CRA2023-0153 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name County Parcel Number 27031300409000 Tenant Name Last Name or Company Name BOTHELL MANOR LLC Apartment or Suite Number Phone Number Extension E-mail Address 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: 2/26/2024 Submitted By: Bob Bozorth Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Building Application #1447279 - Bothell Manor Adult Home Project Contact Company Name: Point of Vision Name: Bob Bozorth Email: PointOfVision@Hotmail.Com Address: 1628 46th Avenue SE Phone #: (425) 772-8207 Everett WA 98203 Project Type Activity Type Scope of Work Single Family Residential New Construction Residence Project Name: Bothell Manor Adult Home Description of Work: Construction of new Single Family Residence - Adult Home Project Details Structure Type Single Family Dwelling Project Information Square Feet - Floor 1 3,223 Square Feet - Floor 2 1,888 Total Bedrooms 13 Total Bathrooms 11 Total Dwelling Units 1 Contact Information BOTHELL MANOR LLC 22422 97TH AVENUE W Owner Email Address EDMONDS, WA 98020 (206)669-4882.....bpmafhllc@gmail.com Page 2 of 2