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BLD2020-1216+Application+11.6.2020_3.46.30_PMCITY OF EDMONDS Sign Application #882640 - Museum Art Panel Applicant First Name Last Name Frances Chapin Number Street Apartment or Suite Numl 121 5th Ave N City State Zip Edmonds WA 98020 Contractor Company Name Owner Number Street City State Zip State License Number License Expiration Date UBI # Project Location MyBoildingPermit.com Company Name City of Edmonds E-mail Address frances.chapin(D-edmondswa.gov Phone Number Extension 4257710228 Apartment or Suite Number Phone Number Extension E-mail Address Number Street Floor Number Suite or Room Number 118 5TH AVE N City Zip Code County Parcel Number EDMONDS 98020 00434202100100 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 EDMONDS CITY OF Number Street Apartment or Suite Number 250 5TH AVE N City State Zip EDMONDS WA 98020-3146 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: 11/6/2020 Submitted By: Frances Chapin Page 1 of 2 i CITY OF EDMONDS MyBui[di ngPerrnit.com Sign Application #882640 - Museum Art Panel Project Contact Company Name: City of Edmonds Name: Frances Chapin Email: frances.chapin@edmondswa.gov Address: 121 5th Ave N Phone #: 4257710228 Edmonds WA 98020 Project Type Nonresidential Activity Type Permanent Sign Project Name: Museum Art Panel Description of Work: Install Museum Art Panel Project Details Sign 1 Type Monument Additional Project Information Total number of signs installed 1 Total number of signs removed 0 Scope of Work Freestanding Page 2 of 2