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BLD2021-0274+Application+2.22.2021_1.21.56_PM+2057877CITY OF EDMONDS MyBuilaingPermit.coin Building Application #925533 - Amen Foundation Repair Applicant First Name Last Name Company Name Barbara Stasiak R&R Foundation Specialist Number Street Apartment or Suite Number E-mail Address 3409 McDougall Ave Suite 204 barbara(�D_rrspecialist.net City State Zip Phone Number Extension Everett WA 98201 4256264841 Contractor Company Name R&R FOUNDATION SPECIALIST LLC Number Street Apartment or Suite Number 3409 McDougall Ave Suite 204 City State Zip Phone Number Extension Everett WA 98201 (425) 760-5077 State License Number License Expiration Date UBI # E-mail Address RRFOUFS829DA 3/1 /2022 604196960 barbara(cD_rrspecialist.net Project Location Number Street Floor Number Suite or Room Number 16706 74TH PL W City Zip Code County Parcel Number EDMONDS 98026 00513100010300 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 Timothy & Maclachlan Stephanie A Amen Number Street Apartment or Suite Number 16706 74TH PL W City State Zip EDMONDS WA 98026 Certification Statement - The applicant states: I 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. I 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: 2/22/2021 Submitted By: Barbara Stasiak Page 1 of 2 CITY OF EDMONDS M BuildingPerrnit.com Building Application #925533 - Amen Foundation Repair Project Contact Company Name: R&R Foundation Specialist Name: Barbara Stasiak Email: barbara@rrspecialist.net Address: 3409 McDougall Ave Suite 204 Phone #: 4256264841 Everett WA 98201 Project Type Activity Type Scope of Work Single Family Residential Remodel Residence Project Name: Amen Foundation Repair Description of Work: crew will install helical piles to stabilize and lift house to maximum practical recovery Project Details Mechanical Included? No mechanical work will occur during this project. Plumbing Included? No plumbing work will occur during this project. Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) Valuation Fair Market Value of Remodeling Work Exterior Changes? The work involves changes to the exterior foundation repair $42, 381 Page 2 of 2