FIR2021-0024+Application+3.9.2021_3.48.02_PM+2083994CITY OF EDMONDS MyBuildingPermit.com
Special Use or Event Application #932803 - DICK'S DRIVE-IN
Applicant
First Name Last Name Company Name
Keith Smith smith co Ilc
Number Street Apartment or Suite Number E-mail Address
603 Stewart Street Suite 610 ksmith(�D_smithco.orq
City State Zip Phone Number Extension
Seattle WA 98101 2067134076
Contractor
Company Name
Number Street
Apartment or Suite Number
City State Zip Phone Number Extension
State License Number License Expiration Date UBI # E-mail Address
Project Location
Number Street Floor Number Suite or Room Number
21910 HWY 99
City Zip Code County Parcel Number
EDMONDS 98026 00580700004008
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
DICK'S DRIVE-INS LTD LP
Number Street Apartment or Suite Number
4426 SECOND AVE NE
City State Zip
SEATTLE WA 98105
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: 3/9/2021 Submitted By: Keith Smith
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CITY OF EDMONDS M BuildingPerrnit.cam
Special Use or Event Application #932803 - DICK'S DRIVE-IN
Project Contact
Company Name: smith co Ilc
Name: Keith Smith Email: ksmith@smithco.org
Address: 603 Stewart Street Suite 610 Phone #: 2067134076
seattle WA 98101
Project Type Activity Type Scope of Work
Any Project Type Special Use Outdoor Seating
Project Name: DICK'S DRIVE-IN
Description of Work: INSTALLATION OF TEMPORARY METAL CANOPY'S
Project Details
Event Location
Private Property
Event Date
Begin Date 3/1/2021
End Date 9/1 /2021
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