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FIR2021-0006+Application+1.13.2021_8.31.34_AM+1987280CITY OF EDMONDS Fire Application #906961 - Veranda build Applicant First Name Last Name Shubert Ho Number Street Apartment or Suite Number 526 Main City State Zip edmonds WA 98020 Contractor Company Name Contractor Unknown Number Street City State License Number Project Location Number Street 526 MAIN ST City EDMONDS Associated Building Permit Number State Zip License Expiration Date UBI # Zip Code County Parcel Number 98020 00434212000900 Tenant Name Fire and the feast Additional Information (i.e. equipment location or special instructions). Work Location Property Owner MyBuildingPermit.com Company Name E-mail Address shubertho@gmail.com Phone Number Extension 2065885148 Apartment or Suite Number Phone Number Extension E-mail Address Floor Number Suite or Room Number 1 None First Name Last Name or Company Name ELSIA LLC Number Street Apartment or Suite Number 18411 AURORA AVE N City State Zip SHORELINE WA 98133 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: 1/13/2021 Submitted By: Shubert Ho Page 1 of 2 i CITY OF EDMONDS MyBui[di ngPerrnit.com Fire Application #906961 - Veranda build Project Contact Company Name: Name: Shubert Ho Email: shubertho@gmail.com Address: 526 Main Phone #: 2065885148 edmonds WA 98020 Project Type Activity Type Any Project Type Special Project Name: Veranda build Description of Work: Building outdoor seating verandas. Project Details Tent Information Tent Dimensions (L ft x W ft) 8x16 Total Number of Tents 4 Will the tent have any vertical sides? Scope of Work Temporary Tent Page 2 of 2