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BLD2023-0584_Application_5.12.2023_4.09.39_PM_3542976CITY OF EDMONDS MyBuildingPermit.com Building Application #1315190 - 9643 Firdale Ave Applicant First Name Last Name Company Name Dimas Cruz La Casa De Amigos LLC Number Street Apartment or Suite Number E-mail Address 9643 Firdale Ave lacasadeamigos1 @gmail.com City State Zip Phone Number Extension Edmonds WA 98020 (626) 766-5121 Contractor Company Name Owner Number Street Apartment or Suite Number City State Zip Phone Number Extension State License Number License Expiration Date UBI # E-mail Address Project Location Number Street Floor Number Suite or Room Number 9643 FIRDALE AVE 1 None City Zip Code County Parcel Number EDMONDS 98020 00449900000100 Associated Building Permit Number Tenant Name FIR2022-0128 Dimas Cruz Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner 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: 5/12/2023 Submitted By: Dimas Cruz Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1315190 - 9643 Firdale Ave 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 Nonresidential New Construction Accessory Building Project Name: 9643 Firdale Ave Description of Work: Covered area for guests Project Details Structure Type Shed or Outbuilding Mechanical Included? No mechanical work will occur during this project. Plumbing Included? No plumbing work will occur during this project. Page 2 of 2