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BLD2021-0897+Application+6.28.2021_9.13.01_AM+2271925CITY OF EDMONDS nnyst,ilaingPermit.com Building Application #983517 - Dusted Valley Tenant Improvement Applicant First Name Last Name Company Name Scott Boyer Mithun Number Street Apartment or Suite Number E-mail Address 12216 Corliss Avenue North boverscott1 @gmail.com City State Zip Phone Number Extension Seattle WA 98133 2062350935 Contractor Company Name Contractor Unknown Number Street Apartment or Suite Number City State License Number Project Location State Zip License Expiration Date UBI # Number Street 201 MAIN ST City Zip Code County Parcel Number EDMONDS 98020 00434400700700 Associated Building Permit Number Tenant Name BLD2016-0506 Dusted Vallev Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Phone Number Extension E-mail Address Floor Number Suite or Room Number 1 102 First Name Last Name or Company Name EDMONDS 2020 LLC Number Street Apartment or Suite Number 307 BELL ST 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: 6/28/2021 Submitted By: Scott Boyer Page 1 of 2 i CITY OF EDMONDS MyBuildingPerrnicot.m „c Building Application #983517 - Dusted Valley Tenant Improvement Project Contact Company Name: Mithun Name: Scott Boyer Email: boyerscott1 @gmail.com Address: 12216 Corliss Avenue North Phone #: 2062350935 Seattle WA 98133 Project Type Activity Type Scope of Work Mixed Use New Construction Primary Building Project Name: Dusted Valley Tenant Improvement Description of Interior remodel of 1,952 SF of existing ground floor space in the Edmonds Mixed Use Work: Building at 2nd and Main Street. T.I. space to be a wine tasting & sales establishment named "Dusted Valley" Project Details Project Information IBC Occupancy type A-2 Construction Type VA Sprink Sub Page 2 of 2