ATTACHMENT 1 PHASE 1 Land Use Applicationi
CITY OF EDMONDS MyBuildinBPermit.com
Land Use Application #1218889 - 611 Main Mixed -Use Building
Applicant
First Name Last Name Company Name
Glenn Safadago GBH Holdings
Number Street Apartment or Suite Number E-mail Address
1389 glennhci@msn.com
City State Zip Phone Number Extension
Edmonds WA 98020 (206) 739-5400
Contractor
Company Name
Number Street Apartment or Suite Number
City State Zip Phone Number Extension
State License Number License Expiration Date uBl # E-mail Address
Project Location
Number Street Floor Number Suite or Room Number
611 MAIN ST
City Zip Code County Parcel Number
EDMONDS 98020 00434209803700
Associated Building Permit Number Tenant Name
Additional Information (i.e. equipment location or special instructions)_
Work Location
Property Owner
First Name Last Name or Company Name
GBH HOLDINGS LLC
Number Street Apartment or Suite Number
PO BOX 1509
City State Zip
LANGLEY WA 98260
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: 10/20/2022 Submitted By: Glenn Safadago
ATTACHMENT 1
Page 1 of 2
CITY OF EDMONDS MyBuildingPermit.com
Land Use Application #1218889 - 611 Main Mixed -Use Building
Project Contact
Company Name: PWF Architecture, LLC
Name: Phil Frisk Email: Phil.Frisk@PWFArchitecture.com
Address: 141 Phone #: (206) 920-3554
Edmonds Washington
98020
Project Type Activity Type
New New Development Activity
Scope of Work
Design Review
Project Name: 611 Main Mixed -Use Building
Description of Demolishing two existing buildings on two adjoining lots and constructing a mixed -use
Work: 3-story building with ground -level commercial space and eighteen apartments, over surface
parking, totaling about 18,000 square feet.
Project Details
Development Type
Multi-Family/Mixed-Use
Page 2 of 2
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MyBuildingPermit.com
Jurisdiction: Edmonds
Project Name: 611 Main Mixed -Use Building
Application ID: 1218889
Supplemental Name: Applicant Certification - Planning
The applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees to release, indemnify,
defend and hold the City of Edmonds harmless from any and all damages, including reasonable attorney's fees, arising from any
action or infraction based in whole or part upon false, misleading, inaccurate or incomplete information furnished by the applicant,
his/her/its agents or employees. The property affected by the application is in the exclusive ownership of the applicant or that the
application has been submitted with the consent of all owners of the affected property.
I certify, under the penalty of perjury under the laws of the State of Washington, that the information and exhibits herewith submitted
are true and correct to the best of my knowledge and that I am authorized to file this application on behalf of the owner of the subject
property.
I do so certify.
('ih/ of Frlmnnrlc
-- -, -------- - - - ---
I
Land Use Application
PS ARCHITECTURAL DESIGN REVIEW • ' • •
❑ COMPREHENSIVE PLAN AMENDMENT
❑ CONDITIONAL USE PERMIT FILE # ZONE
❑ HOME OCCUPATION DATE REC'D BY
❑ FORMAL SUBDIVISION
❑ SHORT SUBDIVISION FEE RECEIPT #
❑ LOT LINE ADJUSTMENT HEARING DATE
❑ PLANNED RESIDENTIAL DEVELOPMENT
❑ OFFICIAL STREET MAP AMENDMENT ❑ HE ❑ STAFF ❑ PB h ADB CC
❑ STREET VACATION
❑ REZONE
❑ SHORELINE PERMIT
❑ VARIANCE / REASONABLE USE EXCEPTION
❑ OTHER:
• PLEASE NOTE THAT ALL INFORMATION CONTAINED WITHIN THE APPLICATION IS A PUBLIC RECORD •
PROPERTY ADDRESS OR LOCATION 605 & 611 Matti Street
PROJECT NAME (IF APPLICABLE) 611 on Matti
PROPERTY OWNER Glenn Safadago PHONE # 206.739.5400
ADDRESS PO Box 1389, Edmonds, WA 98020
E-MAIL G1ennHCI@msn.com FAX # 206.299.4446
TAX ACCOUNT # 004342-098-037-00 (605), 004342-098-037-00 (611) SEC. 24 TWP. 27N RNG, 3E W.M.
DESCRIPTION OF PROJECT OR PROPOSED USE (ATTACH COVER LETTER AS NECESSARY)
Demolishing two existing buildings and constructing a mixed -use
building comprised of 18 apartments and 2,600 square feet of office space, above 20 parking spaces.
DESCRIBE HOW THE PROJECT MEETS APPLICABLE CODES (ATTACH COVER LETTER AS NECESSARY)
The project is a permitted use in the BD2 zoning and will be designed to comply with applicable
building codes, zoning regulations, and comprehensive plan goals.
APPLICANT PWF Architecture/Phil Frisk PHONE # 206.920.3554
ADDRESS PO Box 141, Edmonds, WA 98020
E-MAIL Phil.Frisk@PWFArchitecture.com FAX #
CONTACT PERSON/AGENT Phil Frisk PHONE # 206.920.3554
ADDRESS PO Box 141, Edmonds, WA 98020
E-MAIL Phil.Frisk@PWFArchitecture.com FAX #
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees to
release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable attorney's
fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or incomplete information
furnished by the applicant, his/her/its agents or employees.
By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my knowledge
and that I am authorized to file this application on the behalf of the owner as listed below.
SIGNATURE OF APPLICANVAGENT Rom/^A- 0, T DATE October 17, 2022
Property Owner's Authorization
I Glenn Safadago certify under the penalty of perjury under the laws of the State of
Washington that the following is a true and correct statement: I have authorized the above Applicant/Agent to apply for the
subject land use application, and grant my permission for the public officials and the staff of the City of Edmonds to enter the
subject property for the purposes of inspection and posting attendant to this application.
SIGNATURE OF OWNER GGehvr Sa faolago DATE October 17, 2022
Questions? Call (425) 771-0220.
Revised on 8122112 B - Land Use Application Page I of]