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BLD2021-0926+Application+7.1.2021_11.12.23_AM+2279262CITY OF EDMONDS nn BtaildingPermit.com Building Application #978488 - Office Building Tenant Improvements Applicant First Name Last Name Company Name brent deide cornerstone architectural qroup Number Street Apartment or Suite Number E-mail Address 6161 ne 175th st. 101 bdeide(cb_cornerstonearch.com City State Zip Phone Number Extension kenmore WA 98028 (206) 682-5000 Contractor Company Name Contractor Unknown Number Street Apartment or Suite Number City State License Number Project Location Number Street 7614 195TH ST SW City EDMONDS Associated Building Permit Number State Zip License Expiration Date Phone Number Extension UBI # E-mail Address Floor Number Suite or Room Number 2 200,201 Zip Code County Parcel Number 98026 00539600100100 Tenant Name SUMME MEDICAL CLINIC, PSM, INC. Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name *SVREAL EDMONDS MEDICAL CENTER LLC Number Street Apartment or Suite Number 17338 20TH AVE NW City State Zip SHORELINE WA 98177 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: 7/1/2021 Submitted By: brent deide Page 1 of 2 CITY OF EDMONDS MyBuildingPerrnit.com Building Application #978488 - Office Building Tenant Improvements Project Contact Company Name: cornerstone architectural group Name: steve barnes Email: sbarnes@cornerstonearch.com Address: 6161 ne 175th st. 101 Phone #: 2065509296 kenmore WA 98028 Project Type Nonresidential Project Name: Office Building Tenant Improvements Activity Type Remodel TENANT IMPROVEMENTS TO EXISTING OFFICE BUILDING INCLUDING SELECTIVE Description of DEMOLITION OF INTERIOR PARTITION WALLS, CEILINGS, HVAC, PLUMBING & Work: ELECTRICAL. CONSTRUCTION OF NEW INTERIOR PARTITION WALLS, ACCESSIBLE RESTROOMS, ACOUSTICAL CEILINGS, LIGHTING, HVAC, FLOORING, CASEWORK, ETC. Project Details Project Information Square Feet -Tenant 2,320 Valuation Fair Market Value of Construction Work $40,000 Exterior Changes? The work does not involve changes to the exterior Page 2 of 2