BLD2021-0647+Application+5.10.2021_12.02.16_PM+2187718CITY OF EDMONDS nnyst,ilaingPermit.com
Building Application #961055 - Dr Scott Babin DDS
Applicant
First Name Last Name Company Name
Kelly Newbold David Company LLC
Number Street Apartment or Suite Number E-mail Address
605 19128 112th Ave NE # 605 kelly(�D_davidcompanyllc.com
City State Zip Phone Number Extension
Bothell WA 98011 2069993457
Contractor
Company Name
DAVID COMPANY LLC
Number Street Apartment or Suite Number
19128 112th Ave NE
City State Zip Phone Number Extension
BOTHELL WA 98011 2069993457
State License Number License Expiration Date UBI # E-mail Address
DAVIDCL831B3 1/23/2023 604066860 kelly@davidcompanyllc.com
Project Location
Number Street Floor Number Suite or Room Number
7631 212TH ST SW 1 109C
City Zip Code County Parcel Number
EDMONDS 98026 00614300001701
Associated Building Permit Number Tenant Name
Dr Scott Babin DDS
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
First Name Last Name or Company Name
Samir OASIS INC
Number Street Apartment or Suite Number
15516 129TH AVE NE
City State Zip
WOODINVILLE WA 98072
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: 5/10/2021 Submitted By: Kelly Newbold
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CITY OF EDMONDS MyBui[di ngPerrnit.com
Building Application #961055 - Dr Scott Babin DDS
Project Contact
Company Name: David Company LLC
Name: Kelly Newbold Email: kelly@davidcompanyllc.com
Address: 605 605 19128 112th Ave NE # Phone #: 2069993457
Bothell WA 98011
Project Type
Nonresidential
Activity Type
Remodel
Project Name: Dr Scott Babin DDS
Description of Work: Minor interior alterations of an existing dental clinic. Modding space to fit 3
additional operatories
Project Details
Project Information
Square Feet -Tenant 1,547
Valuation
Fair Market Value of Construction Work $65,000
Exterior Changes?
The work does not involve changes to the exterior
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