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BLD2021-0659+Application+5.12.2021_10.20.05_AM+2183991CITY OF EDMONDS Building Application #959745 - Alexander's Applicant First Name Last Name Sam Savar Number Street Apartment or Suite Number 3221 NE 200th St City State Zip Lake Forest Park WA 98155 Contractor Company Name Owner Number Street City State License Number Project Location Number Street 401 MAIN ST City EDMONDS Associated Building Permit Number State Zip License Expiration Date UBI # Zip Code County Parcel Number 98020 00434400101202 Tenant Name vacant Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name Gregory C & Deborah J Wilson Number Street PO BOX 1298 MyBuildingPermit.com Company Name Alexanders Bazaar Inc E-mail Address savars(&-yahoo.com Phone Number Extension 2069793214 Apartment or Suite Number Phone Number Extension E-mail Address Floor Number Suite or Room Number 1 407 Apartment or Suite Number City State Zip EDMONDS WA 98020 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: 5/12/2021 Submitted By: Sam Savar Page 1 of 2 i CITY OF EDMONDS MyBui[di ngPerrnit.com Building Application #959745 - Alexander's Project Contact Company Name: Alexander's Name: Sam Savar Email: savars@yahoo.cpm Address: 3221 NE 200th St Phone #: 206-979-3214 Lake Forest Park Wa 98155 Project Type Nonresidential Activity Type Tenant Improvement - Change of Use Project Name: Alexander's Description of Work: We plan to add new flooring, repaint interior and exterior, move one interior wall and add glass cases and a checkout stand for retail. Project Details Project Information IBC Occupancy type retail Square Feet -Tenant 665 Use Information This is a change of use. Page 2 of 2