BLD2021-1711+Application+12.17.2021_3.14.54_PM+2580551CITY OF EDMONDS nnyst,ilaingPermit.com
Building Application #1066091 -Uptown City Office
Applicant
First Name Last Name Company Name
Thom Sullivan City of Edmonds
Number Street Apartment or Suite Number E-mail Address
7110 210 st. SW thom.sullivan(.@_edmondswa.gov
City State Zip Phone Number Extension
Edmonds WA 98026 4257603334
Contractor
Company Name
Contractor Unknown
Number Street
City
State License Number
Project Location
Number Street
23632 HIGHWAY 99
City
EDMONDS
Associated Building Permit Number
State Zip
License Expiration Date UBI #
Zip Code County Parcel Number
98026 00451900100401
Tenant Name
City of Edmonds
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
Apartment or Suite Number
Phone Number Extension
E-mail Address
Floor Number Suite or Room Number
1 1
First Name Last Name or Company Name
*Regency Centers Corperation
Number Street Apartment or Suite Number
One Suite 114
City State Zip
Jacksonville FL 32202
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: 12/17/2021 Submitted By: Thom Sullivan
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CITY OF EDMONDS MyBuildingPermit.com
Building Application #1066091 -Uptown City Office
Project Contact
Company Name: City of Edmonds
Name: Thom Sullivan Email: thom.sullivan@edmondswa.gov
Address: 7110 210 st. SW Phone #: 4257603334
Edmonds WA 98026
Project Type
Nonresidential
Activity Type
Tenant Improvement
Project Name: Uptown City Office
Description of Work: Add small non-structural wall and door
Project Details
Project Information
Square Feet -Tenant
Use Information
Use - existing
Use - proposed
Valuation
Fair Market Value of Construction Work
Exterior Changes?
The work does not involve changes to the exterior
1,150
Vacant office space
Convert vacant office to new City office
$5,000
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