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BLD2022-0586+Application+5.7.2022_11.55.09_AM+2854481CITY OF EDMONDS nnyst,ilaingPermit.com Building Application #1119342 - Change of use Pilates, Massage Applicant First Name Last Name Company Name Michael Crouch WoodWay Wellness Number Street Apartment or Suite Number E-mail Address 505 5th ave S 3A mikeperouch(.@_gmail.com City State Zip Phone Number Extension Edmonds WA 98020 8583528044 Contractor Company Name Contractor Unknown Number Street Apartment or Suite Number City State License Number Project Location Number Street 505 5TH AVE S City EDMONDS Associated Building Permit Number State Zip License Expiration Date Phone Number Extension UBI # E-mail Address Zip Code County Parcel Number 98020 01070900000300 Tenant Name Karla Crouch Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Floor Number Suite or Room Number Main floor 103 First Name Last Name or Company Name PARAGEN PROPERTIES II LLC Number Street Apartment or Suite Number 23929 W WOODWAY LN City State Zip WOODWAY WA 98020-5229 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: 5/7/2022 Submitted By: Michael Crouch Page 1 of 2 i o CITY OF EDMONDS MyBuildingPerrnit.cm „c Building Application #1119342 - Change of use Pilates, Massage Project Contact Company Name: WoodWay Wellness Name: Michael Crouch Email: mikeperouch@gmail.com Address: 505 5th ave S 3A Phone #: 8583528044 Edmonds WA 98020 Project Type Nonresidential Activity Type Tenant Improvement - Change of Use Project Name: Change of use Pilates, Massage Description of Work: New paint. Project Details Project Information Square Feet -Tenant Use Information Use - existing Use - proposed Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) 1,131 Jewelry store Pilates, massage Entire space Page 2 of 2