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FIR2022-0045+Application+4.28.2022_1.32.37_PM+2834437CITY OF EDMONDS nn BtaildingPermit.com Special Use or Event Application #1132136 - Courtyard Temporary tent Applicant First Name Last Name Company Name Niko Raptis The Loft Cafe Number Street Apartment or Suite Number E-mail Address 515 Main Street the1oft515m(&_gmai1.com City State Zip Phone Number Extension Edmonds WA 98020 2067784848 Contractor Company Name Number City State License Number Project Location Street State Zip License Expiration Date Number Street City Zip Code Associated Building Permit Number Additional Information (i.e. equipment location or special instructions). Work Location The Loft courtyard Property Owner First Name Number Street City State UBI # County Parcel Number Tenant Name Last Name or Company Name Certification Statement - The applicant states: Zip Apartment or Suite Number Phone Number Extension E-mail Address Floor Number Suite or Room Number Apartment or Suite Number 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: 4/28/2022 Submitted By: Niko Raptis Page 1 of 2 i CITY OF EDMONDS MyBoi[di ngPerrnit.com Special Use or Event Application #1132136 - Courtyard Temporary tent Project Contact Company Name: Name: Address: Project Type Any Project Type Niko Raptis 515 Main Street Edmonds WA 98020 Email: theloft515m@gmail.com Phone #: 2067784848 Activity Type Special Use Scope of Work Outdoor Seating Project Name: Courtyard Temporary tent Description of We are applying for a temporary tent permit for the Loft's courtyard area. All dimensions Work: and materials are staying the same as they have been with existing temporary permit. Thank you! Project Details Event Location Private Property Event Date Begin Date 5/1/2022 End Date 10/31 /2022 Page 2 of 2