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BLD2022-0886+Application+7.6.2022_4.40.46_PM+2973751CITY OF EDMONDS MyBuildingPermit.com Building Application #1169369 - RUSTY PELICAN CAFE Applicant First Name Last Name Company Name KWANGHYUN BAEK UIL ARCHITECTS Number Street Apartment or Suite Number E-mail Address 1800 136th PL NE Suite 207 dkb(.@_uilarchitects.com City State Zip Phone Number Extension Bellevue WA 98005 (425) 635-8914 Contractor Company Name Contractor Unknown Number Street City State License Number Project Location Number Street 107 5TH AVE N City EDMONDS Associated Building Permit Number State Zip License Expiration Date Phone Number UBI # E-mail Address Floor Number 1 Zip Code County Parcel Number 98020 00434400100101 Tenant Name RUSTY PELICAN CAFE Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Apartment or Suite Number Extension Suite or Room Number none First Name Last Name or Company Name THIRD AVENUE SOUTH PROPERTIES LLC Number Street Apartment or Suite Number 8451 SE 68TH ST 200 City State Zip MERCER ISLAND WA 98040 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: 7/6/2022 Submitted By: KWANGHYUN BAEK Page 1 of 2 CITY OF EDMONDS MYBuildingPerrnit.com Building Application #1169369 - RUSTY PELICAN CAFE Project Contact Company Name: UIL ARCHITECTS Name: KWANGHYUN BAEK Email: dkb@uilarchitects.com Address: 1800 136th PL NE Suite 207 Phone #: (425) 635-8914 Bellevue WA 98005 Project Type Nonresidential Activity Type Remodel Project Name: RUSTY PELICAN CAFE Description of Work: NON-STRUCTURAL INTERIOR REMODEL AT BEVERAGE BAR AND RECEPTION COUNTER AREA TO AN EXISTING RESTAURANT PER PLAN. Project Details Project Information Square Feet -Tenant 2,360 Valuation Fair Market Value of Construction Work $45,000 Exterior Changes? The work does not involve changes to the exterior Page 2 of 2