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BLD2025-0095+Application+1.22.2025_10.27.52_AM+4722805CITY OF EDMONDS MyBuildingPermit.com Building Application #1604216 - Fence Applicant First Name Last Name Company Name Wafiyah Khalil Number Street Apartment or Suite Number E-mail Address 23516 84th Ave W City State Zip Edmonds WA 98026 Contractor Company Name Contractor Unknown Number Street anna.m.othman(a),gmail.com Phone Number Extension (206) 412-5556 Apartment or Suite Number City State Zip Phone Number Extension State License Number License Expiration Date UBI # E-mail Address Project Location Number Street Floor Number Suite or Room Number 23516 84TH AVE W City Zip Code County Parcel Number EDMONDS 98026 27043100208500 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name Adam Othman Number Street Apartment or Suite Number 23516 84TH AVE W 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: 1/22/2025 Submitted By: Wafiyah Khalil Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1604216 - Fence Project Contact Company Name: Name: Address: Wafiyah Khalil 23516 84th Ave W Edmonds WA 98026 Project Type Single Family Residential Email: anna.m.othman@gmail.com Phone #: (206) 412-5556 Activity Type New Construction Project Name: Fence Description of Work: 6-foot fence on East side of property Project Details Scope of Work Fence Work Location Work Description/Location (example: 1 st floor, East side of property Master Bath, Garage) Contact Information Owner Email Address anna.m.othman@gmail.com Page 2 of 2