BLD2021-1456+Application+10.22.2021_6.16.26_PM+2479510CITY OF EDMONDS MyBuilaingPermit.com
Building Application #1039400 - Seattle Skin and Laser
Applicant
First Name Last Name Company Name
Gina Dais TGB Architects
Number Street Apartment or Suite Number E-mail Address
21911 76th Ave W 210 gdais@tgbarchitects.com
City State Zip Phone Number Extension
Edmonds WA 98026 4255594463
Contractor
Company Name
BP CONTRACTING
Number Street Apartment or Suite Number
31908 NE 114TH PL
City State Zip Phone Number Extension
CARNATION WA 98014 (206)384-9871
State License Number License Expiration Date UBI # E-mail Address
BPCONC*942QP 11/17/2022 602669836 bpollestad@hotmail.com
Project Location
Number Street Floor Number
21727 76TH AVE W 2
City Zip Code County Parcel Number
EDMONDS 98026 00580700002701
Associated Building Permit Number Tenant Name
Seattle Skin and Laser
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
First Name
Number Street
PO BOX 92129
Last Name or Company Name
HR ACQUISITION I CORPORATION
Suite or Room Number
f
Apartment or Suite Number
City State Zip
SOUTH LAKE TX 76092
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: 10/22/2021 Submitted By: Gina Dais
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CITY OF EDMONDS Mysu;laingPerrnit.com
Building Application #1039400 - Seattle Skin and Laser
Project Contact
Company Name: Seattle Skin and Laser
Name: Kari Thomas Email: kthomas@island-derm.com
Address: 21701 76th ave w 100 Phone #: (206) 525-1168
Edmonds wa 98026
Project Type
Nonresidential
Activity Type
Tenant Improvement
Project Name: Seattle Skin and Laser
Description of Work: Remodel of existing administrative area into clinical exam rooms and reception
area.
Project Details
Project Information
Square Feet -Tenant
1,876
Use Information
Use - existing
Business
Use - proposed
Business
Valuation
Fair Market Value of Construction Work
$375,200
Exterior Changes?
The work does not involve changes to the exterior
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