ENG2022-0105+Application+3.13.2022_8.22.50_AM+2731222-1; CITY OF EDMONDS MyBuildingPermit.com
Right -of -Way Application #1105930 - 7315 212th St SW N.523907 (CTLNWA-33097)
Applicant
First Name Last Name
Company Name
Tracey Tipton
CenturyLink (Lumen -National)
Number Street
Apartment or Suite Number E-mail Address
22817 SE Issaquah -Fall City Rd
tracey.tipton(D_Iumen.com
City State Zip
Phone Number Extension
Issaquah WA 98027
(206) 947-9370
Contractor
Company Name
NORTH SKY COMMUNICATIONS LLC
Number Street
Apartment or Suite Number
11818 S.E. Mill Plain Blvd
#410
City State Zip
Phone Number Extension
Vancouver WA 98684
(360) 254-6920
State License Number License Expiration Date
UBI # E-mail Address
NORTHSC958NE 8/14/2017
601973572 rdautrich@northskycomm.com
Project Location
Number Street
Floor Number Suite or Room Number
7315 212TH ST SW
City Zip Code
County Parcel Number
EDMONDS 98026
00566900500600
Associated Building Permit Number
Tenant Name
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
First Name Last Name or Company Name
GAHC4 EDMONDS WA MOB LLC
Number Street Apartment or Suite Number
18191 VON KARMAN AVE
City State Zip
IRVINE CA 92612
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: 3/13/2022 Submitted By: Tracey Tipton
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Right -of -Way Application #1105930 - 7315 212th St SW_ N.523907 (CTLNWA-33097)
Project Contact
Company Name: K&B TECHNICAL SOLUTIONS
Name: Glen Williams Email: glen_williams@kbmail.net
Address: PO Box 2529 Phone #: 5034759232
Clackamas OR 97115
Project Type
Utility Purveyor
Activity Type
Utility Work
Scope of Work
Disturbance of Surface
Project Name: 7315 212th St SW_ N.523907 (CTLNWA-33097)
Description of Work: CenturyLink (Lumen -National) is proposing to bore a min of 36" below grade and install
new conduit and fiber optic cable on Pacific Hwy and 212th St SW.
Project Details
Project Information
Job Number
N.523907
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