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BLD2022-1622+Application+11.23.2022_1.18.21_PM+3236539CITY OF EDMONDS 6U Sign Application #1234179 - Xfinity Applicant First Name Last Name Tony Le Number Street 7808 River Rd East City State Zip Puyallup WA 98371 Contractor Company Name Contractor Unknown Number Street City State Zip State License Number License Expiration Date UBI # Project Location Number Street 23632 HIGHWAY 99 City Zip Code EDMONDS 98026 Associated Building Permit Number Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Number Street PO BOX 2539 MyBuildingPermit.com Company Name US SIGN 1 LLC Apartment or Suite Number E-mail Address ussignllc@gmail.com Phone Number Extension (206) 468-3999 Apartment or Suite Number Phone Number Extension E-mail Address Floor Number Suite or Room Number A County Parcel Number 00451900100401 Tenant Name Xfinity Last Name or Company Name FW WA -AURORA MARKETPLACE LLC Apartment or Suite Number 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: 11/23/2022 Submitted By: Tony Le Page 1 of 2 i CITY OF EDMONDS MyBui[di ngPerrnit.com Sign Application #1234179 - Xfinity Project Contact Company Name: US SIGN 1 LLC Name: Tony Le Email: ussignllc@gmail.com Address: 7808 River Rd East Phone #: (206) 468-3999 Puyallup WA 98371 Project Type Nonresidential Activity Type Permanent Sign Scope of Work Wall or Building Project Name: Xfinity Description of Work: Install of two (set) channel letters flush mount to the wall. Signs will be LED illumination. Install of two tenant panel. Structure by other. Project Details Sign 1 Type Channel Letters Additional Project Information Total number of signs installed 2 Total number of signs removed 0 Page 2 of 2