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ENG2022-0497+Application+10.5.2022_1.34.17_PM+3147828-1; CITY OF EDMONDS MyBuildingPermit.com Right -of -Way Application #1211765 - Table for 12 Sign Street Use Applicant First Name Last Name Company Name Rian Cool Great Life Publishinq LLC Number Street Apartment or Suite Number E-mail Address 320 5th Ave S B rian((:D_greatergood.com City State Zip Phone Number Extension Edmonds WA 98020 (206) 375-4146 Contractor Company Name Haider Construction Number Street Apartment or Suite Number 5607 244th St. SW City State Zip Phone Number Extension Mountlake Terrace WA 98043 2063754146 State License Number License Expiration Date UBI # E-mail Address HAIDEC*914DB 4/7/2023 602903374 rian@greatergood.com Project Location Number Street Floor Number Suite or Room Number 320 5TH AVE S City Zip Code County Parcel Number EDMONDS 98020 27032300413000 Associated Building Permit Number Tenant Name BLD2022-1215 Table for 12 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name * VOLTSIS VENTURES LLC Number Street Apartment or Suite Number 320 5TH AVE City State Zip EDMONDS WA 98020 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: 10/5/2022 Submitted By: Rian Cool Page 1 of 2 i MyBuildingPerrnit.com CITY OF EDMONDS .•„•„ Right -of -Way Application #1211765 - Table for 12 Sign Street Use Project Contact Company Name: Great Life Publishing LLC Name: Rian Cool Email: rian@greatergood.com Address: 320 5th Ave S B Phone #: (206) 375-4146 Edmonds WA 98020 Project Type Activity Type Scope of Work Nonresidential Street Use Objects Temporary in Nature Project Name: Table for 12 Sign Street Use Description of Work: Street Use Permit for building sign @ 320 5th Ave S (Table for 12 location) Project Details Project Information Other Project Start Proposed start date 10/17/2022 Project End Proposed end date 10/15/2027 Page 2 of 2