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FIR2020-0103+Application+11.25.2020_5.38.40_PM (2)CITY OF EDMONDS nn BtaildingPermit.com Special Use or Event Application #890341 - Las Brisas Canopy For patio Applicant First Name Last Name Company Name Alvaro Castillo Las Brisas Number Street Apartment or Suite Number E-mail Address 201 5Th Ave S Ste 101 City State Zip Edmonds WA 98020 Contractor Company Name Number Street City State License Number Project Location Number Street 201 5TH AVE S City EDMONDS Associated Building Permit Number State Zip License Expiration Date UBI # Zip Code 98020 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner County Parcel Number 00434212100100 Tenant Name service(D_Iasbrisasfood.com Phone Number Extension 4252364405 Apartment or Suite Number Phone Number Extension E-mail Address Floor Number Suite or Room Number First Name Last Name or Company Name R H OLD MILL TOWN ASSOC LLC Number Street Apartment or Suite Number PO BOX 5003 City State Zip BELLEVUE WA 98009 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: 11/25/2020 Submitted By: Alvaro Castillo Page 1 of 2 i CITY OF EDMONDS Mygui[di ngPerrnit.com ,.,I,,.. Special Use or Event Application #890341 - Las Brisas Canopy For patio Project Contact Company Name: Las Brisas Name: Alvaro Castillo Email: service@lasbrisasfood.com Address: 201 5Th Ave S Ste 101 Phone #: 4252364405 Edmonds WA 98020 Project Type Activity Type Scope of Work Any Project Type Special Use Outdoor Seating Project Name: Las Brisas Canopy For patio Description of Work: due to the current COVID-19 situation, we are trying to put canopy in our patio Project Details Event Location Private Property Event Date Begin Date 12/1/2020 End Date 10/1/2021 Page 2 of 2