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BLD2023-0498+Application+4.21.2023_1.15.44_PM+3498194CITY OF EDMONDS MyBoildingPermit.com Building Application #1302781 - Edmonds professional Center Applicant First Name Last Name Company Name Kevin DuBois Installer Direct Number Street Apartment or Suite Number E-mail Address 21604 148th Ave SE installerdirect((:D_outlook.com City State Zip Phone Number Extension Kent WA 98042 (206) 234-9133 Contractor Company Name DUBOIS, KEVIN Number Street Apartment or Suite Number 21604 148th Ave S.E. City State Zip Phone Number Extension Kent WA 98042 2532934007 State License Number License Expiration Date UBI # E-mail Address DUBOIK*033CS 6/27/2024 601762367 installerdirect(cb_outlook.com Project Location Number Street Floor Number Suite or Room Number 7315 212TH ST SW 2 208/209 City Zip Code County Parcel Number EDMONDS 98026 00566900500600 Associated Building Permit Number Tenant Name Quest Diaqnostic Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name * GAHC4 EDMONDS WA MOB LLC Number Street Apartment or Suite Number 18191 VON KARMAN AVE City State Zip IRVINE CA 92612 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: 4/21/2023 Submitted By: Kevin DuBois Page 1 of 2 CITY OF EDMONDS M BuildingPerrnit.com Building Application #1302781 - Edmonds professional Center Project Contact Company Name: Installer Direct Name: Kevin DuBois Email: installerdirect@outlook.com Address: 21604 148th Ave SE Phone #: (206) 234-9133 Kent WA 98042 Project Type Nonresidential Activity Type Tenant Improvement Project Name: Edmonds professional Center Description of 208-209 had a wall removed by previous owners and now we are changing it back to a Work: divided space. We are replacing a wall in a passage that is 3ft 7in by 6ft 7in tall. We used 5/8 sheet rock over metal studs, finished and painted to match. Project Details Project Information Square Feet -Tenant Use Information Use - existing Use - proposed Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) 1,100 There are two tenants in the spaces 208-209, Edmonds eye clinic (Dr.Andy) and 209 is Quest Diagnostic 208 and 209 where combined for the last owners and now we are putting the dividing passage back up to create 208 and 209 separation again 2nd floor street level access, we are changing a combined space back to it original two spaces. We added a wall between 208-209 3ft7in by 6ft7in that was once a wall and removed and now replaced. We used 5/8 sheet rock and metal studs. Valuation Fair Market Value of Construction Work $1,500 Exterior Changes? The work does not involve changes to the exterior Page 2 of 2