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BLD2023-0172+Application+2.10.2023_12.52.40_PM+3363681CITY OF EDMONDS nnyst,ilaingPermit.com Building Application #1267030 - Civic Park Public Art Applicant First Name Last Name Company Name Frances Chapin City of Edmonds Number Street Apartment or Suite Number E-mail Address 121 5th Ave N frances.chapin(D_edmondswa.gov City State Zip Phone Number Extension Edmonds WA 98020 (425) 771-0228 Contractor Company Name Contractor Unknown Number Street City State License Number Project Location Number Street 310 6TH AVE N City EDMONDS Associated Building Permit Number State Zip License Expiration Date UBI # Zip Code County Parcel Number 98020 00434210000000 Tenant Name City of Edmonds Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Apartment or Suite Number Phone Number Extension E-mail Address Floor Number Suite or Room Number 1 N/A First Name Last Name or Company Name CITY OF EDMONDS Number Street Apartment or Suite Number 700 MAIN ST 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: 2/10/2023 Submitted By: Frances Chapin Page 1 of 2 i o CITY OF EDMONDS MyBuildingPerrnit.cm „c Building Application #1267030 - Civic Park Public Art Project Contact Company Name: City of Edmonds Name: Frances Chapin Email: frances.chapin@edmondswa.gov Address: 121 5th Ave N Phone #: (425) 771-0228 Edmonds WA 98020 Project Type Nonresidential Activity Type Remodel Project Name: Civic Park Public Art Description of Work: Suspended boat form artwork inside of shade structure as part of installation called Lifeboat and Seawall by Clark Wiegman. Percent for art project for Civic Park. Project Details Valuation Fair Market Value of Construction Work $70,000 Exterior Changes? The work does not involve changes to the exterior Page 2 of 2