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FIR2022-0128+Application+11.21.2022_11.38.55_AM+3185521CITY OF EDMONDS nnyst,ilaingPermit.com Special Use or Event Application #1220381 - La Casa De Amigos LLC Applicant First Name Last Name Company Name Dimas Cruz La Casa De Amiqos LLC Number Street Apartment or Suite Number E-mail Address 9643 Firdale Ave lacasadeamigos1(cD_gmail.com City State Zip Phone Number Extension Edmonds WA 98020 (626) 766-5121 Contractor Company Name Number Street City State License Number Project Location State Zip License Expiration Date UBI # Number Street 9643 FIRDALE AVE City Zip Code County Parcel Number EDMONDS 98020 00449900000100 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Apartment or Suite Number Phone Number Extension E-mail Address Floor Number Suite or Room Number First Name Last Name or Company Name FIRDALE ASSOCIATES LLC Number Street Apartment or Suite Number 9500 ROOSEVELT WAY NE 100 City State Zip SEATTLE WA 98115 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: 11/21/2022 Submitted By: Dimas Cruz Page 1 of 2 i CITY OF EDMONDS MyBui[di ngPerrnit.com Special Use or Event Application #1220381 - La Casa De Amigos LLC Project Contact Company Name: La Casa De Amigos LLC Name: Dimas Cruz Email: lacasadeamigos1@gmail.com Address: 9643 Firdale Ave Phone #: (626) 766-5121 Edmonds WA 98020 Project Type Activity Type Scope of Work Any Project Type Special Use Outdoor Seating Project Name: La Casa De Amigos LLC Description of Work: Covering structure for la Casa De Amigos customers. Project Details Event Location Private Property Event Date Begin Date 11/15/2022 End Date 10/15/2023 Page 2 of 2