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BLD2021-0692+Application+5.19.2021_10.09.26_AM+2205259CITY OF EDMONDS MyBuildingPermit.com Building Application #965626 - Vinbero Windows Applicant First Name Last Name Company Name levi masciotra CENTERLINE HOMES LLC Number Street Apartment or Suite Number E-mail Address po box 61 levi(�D_clhhomes.com City State Zip Phone Number Extension Mountlake Terrace WA 98043 4252317065 Contractor Company Name CENTERLINE HOMES LLC Number Street Apartment or Suite Number PO Box 61 City State Zip Phone Number Extension MOUNTLAKE WA 98043 (425)231-7065 State License Number License Expiration Date UBI # F-mail Address CENTEHL832KN 6/1 /2021 604114125 levi@clhhomes.com Project Location Number Street Floor Number Suite or Room Number 203 5TH AVE S 1st Floor Suite 1 City Zip Code County Parcel Number EDMONDS 98020 00434212103700 Associated Building Permit Number Tenant Name Vinbero Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Number Street PO BOX 5003 Last Name or Company Name R H OLD MILL TOWN ASSOC LLC Apartment or Suite Number City State Zip BELLEVUE WA 98009 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: 5/19/2021 Submitted By: levi masciotra Page 1 of 2 i CITY OF EDMONDS MyBui[di ngPerrnit.com Building Application #965626 - Vinbero Windows Project Contact Company Name: Centerline Homes, LLC Name: Levi Masciotra Email: levi@clhhomes.com Address: Po Box 61 Phone #: 425-231-7065 Mountlake Terrace WA 98043 Project Type Nonresidential Activity Type Remodel Project Name: Vinbero Windows Description of Work: Replacing 3 Windows at the store front, no framing will be required because we are using windows that are the same size as existing. Project Details Project Information Square Feet -Tenant 900 Valuation Fair Market Value of Construction Work $10,500 Exterior Changes? The work involves changes to the exterior Page 2 of 2