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BLD2022-0812+Application+6.22.2022_9.42.24_AM+2947066CITY OF EDMONDS MyBuildingPermit.com Sign Application #1162652 - T-Mobile exterior sign refresh Applicant First Name Last Name Company Name Hans Visser Culbertson Siqn Service Number Street Apartment or Suite Number E-mail Address 5209 122nd Street East csspermits(@gmail.com City State Zip Phone Number Extension Tacoma WA 98446 (253) 538-0752 Contractor Company Name CULBERTSON SIGN SERVICE LLC Number Street Apartment or Suite Number 5209 122nd Street East City State Zip Phone Number Extension Tacoma WA 98446 (253) 538-0752 State License Number License Expiration Date UBI # E-mail Address CULBESS8421\16 8/26/2022 602043276 csspermits(D_gmail.com Project Location Number Street Floor Number Suite or Room Number 23632 HIGHWAY 99 Suite K City Zip Code County Parcel Number EDMONDS 98026 00451900100401 Associated Building Permit Number Tenant Name T-Mobile Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name FW WA -AURORA MARKETPLACE LLC Number Street Apartment or Suite Number PO BOX 2539 City State Zip SAN ANTONIO TX 78299 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: 6/22/2022 Submitted By: Hans Visser Page 1 of 2 i o CITY OF EDMONDS MyBuildingPerrnit.cm „c Sign Application #1162652 - T-Mobile exterior sign refresh Project Contact Company Name: Culbertson Sign Service Name: Hans Visser Email: csspermits@gmail.com Address: 5209 122nd Street East Phone #: (253) 538-0752 Tacoma WA 98446 Project Type Nonresidential Activity Type Permanent Sign Scope of Work Wall or Building Project Name: T-Mobile exterior sign refresh Description of Work: Install one internally illuminated wall sign on the tenant's main (south) exterior facade. Project Details Sign 1 Type Building Mounted Additional Project Information Total number of signs installed 1 Total number of signs removed 1 Page 2 of 2