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FIR2021-0049+Application+5.16.2021_9.24.23_AM+2199061CITY OF EDMONDS Fire Application #963914 - Campbell Temp tent Applicant First Name Last Name Robin Michel Number Street Apartment or Suite Number 7305 Soundview Drive City State Zip Edmonds WA 98026 Contractor Company Name Reqent Construction Inc Number Street 7305 Soundview Dr City State Zip EDMONDS WA 98026 State License Number License Expiration Date UBI # REGENC1891 K5 5/25/2023 603055500 Project Location Number Street 24015 84TH AVE W City Zip Code County Parcel Number EDMONDS 98026 00491100000108 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions). Work Location Property Owner MyBuildingPermit.com Company Name Michel Design E-mail Address rwmichel1 �D-me.com Phone Number Extension 2069302445 Apartment or Suite Number Phone Number Extension 8324233879 E-mail Address rwmichel1 @me.com Floor Number Suite or Room Number 1 First Name Last Name or Company Name CAMNEL PROPERTIES LLC Number Street Apartment or Suite Number 24329 HW 99 City State Zip EDMONDS WA 98026 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: 5/16/2021 Submitted By: Robin Michel Page 1 of 2 i CITY OF EDMONDS MyBui[di ngPerrnit.com Fire Application #963914 - Campbell Temp tent Project Contact Company Name: Michel Design Name: Robin Michel Email: rwmichel1@me.com Address: 7305 Soundview Drive Phone #: 2069302445 Edmonds WA 98026 Project Type Any Project Type Activity Type Special Project Name: Campbell Temp tent Description of Work: Install tent structure 14' x 20' Project Details Tent Information Tent Dimensions (L ft x W ft) Total Number of Tents Scope of Work Temporary Tent Page 2 of 2