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BLD2021-0202+Application+2.3.2021_9.45.29_PM+2032091CITY OF EDMONDS nnyst,ilaingPermit.com Building Application #918679 - Wheelchair ramp Applicant First Name Last Name Company Name fames tate Number Street Apartment or Suite Number E-mail Address 23329 highway 99 anyandallpm(cD_gmail.com City State Zip Phone Number Extension edmonds WA 98026 3607209080 Contractor Company Name Owner Number Street City State License Number Project Location State Zip License Expiration Date Number Street 23329 99 HWY S City Zip Code EDMONDS 98026 Associated Building Permit Number 2020-0018 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Phone Number UBI # E-mail Address Floor Number 1 County Parcel Number 00576700002004 Tenant Name Edmonds Smoke and Mini Mart Apartment or Suite Number Extension Suite or Room Number none2 First Name Last Name or Company Name fames Tate Number Street Apartment or Suite Number 23329 highway 99 City State Zip edmonds WASHINGT 98026 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: 2/3/2021 Submitted By: james tate Page 1 of 2 i CITY OF EDMONDS MyBui[di ngPerrnit.com Building Application #918679 - Wheelchair ramp Project Contact Company Name: Name: Address: Michael Breuer 23329 highway 99 edmonds WA 98026 Email: anyandallpm@gmail.com Phone #: 3607209080 Project Type Activity Type Scope of Work Nonresidential New Construction Deck, Uncovered Project Name: Wheelchair ramp Description of Work: building wheel chair access ramp for main entrance of store. Project Details Structure Type Deck Project Information Square Feet - Deck 236 Page 2 of 2