BLD2021-0708+Application+5.24.2021_11.31.10_AM+2213048CITY OF EDMONDS nnysuilaingPermit.com
Building Application #967712 - MTI Physical Therapy
Applicant
First Name Last Name Company Name
David Sova Architect David Sova
Number Street Apartment or Suite Number E-mail Address
16915 SE 272nd Street Suite 100-180 david(�D_dsdaa.com
City State Zip Phone Number Extension
Covinqton WA 98042 2066179010
Contractor
Company Name
Contractor Unknown
Number Street
City
State License Number
Project Location
Number Street
21616 76TH AVE W
City
EDMONDS
Associated Building Permit Number
State Zip
License Expiration Date
Phone Number
UBI # E-mail Address
Zip Code County Parcel Number
98026 00461000100101
Tenant Name
MTI Physical Therapy
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
Floor Number
1
Apartment or Suite Number
Extension
Suite or Room Number
102
First Name Last Name or Company Name
HR ACQUISITION I CORPORATION
Number Street Apartment or Suite Number
3310 West End Ave ND AVE STE 700
City State Zip
NASHVILLE TN 37203
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: 5/24/2021 Submitted By: David Sova
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CITY OF EDMONDS MyBuildingPermit.com
Building Application #967712 - MTI Physical Therapy
Project Contact
Company Name: Architect David Sova
Name: David Sova Email: david@dsdaa.com
Address: 16915 SE 272nd Street Suite 100-180 Phone #: 2066179010
Covington WA 98042
Project Type
Nonresidential
Activity Type
Tenant Improvement
Project Name: MTI Physical Therapy
Description of Work: Interior Alterations to an existing medical office space
Project Details
Project Information
Square Feet -Tenant 2,675
Use Information
Use - existing Medical Office
Use - proposed Medical Office
Valuation
Fair Market Value of Construction Work $207,625
Exterior Changes?
The work does not involve changes to the exterior
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