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BLD2022-0977+Application+7.21.2022_3.56.43_PM+2822291CITY OF EDMONDS nnyst,ilaingPermit.com Building Application #1130113 - Center Annex Applicant First Name Last Name Company Name Greqory Jantz The Center A Place of HOPE Number Street Apartment or Suite Number E-mail Address P.O.Box 700 drjantz(D_aplaceofhope.com City State Zip Phone Number Extension Edmonds WA 98020 (206) 947-6415 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 533 DAYTON ST all none City Zip Code County Parcel Number EDMONDS 98020 00434212002800 Associated Building Permit Number Tenant Name The Center A Place of HOPE Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name Gregory Jantz Number Street Apartment or Suite Number PO BOX 700 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: 7/21/2022 Submitted By: Gregory Jantz Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1130113 - Center Annex Project Contact Company Name: The Center A Place of HOPE Name: Gregory Jantz Email: drjantz@aplaceofhope.com Address: P.O.Box 700 Phone #: (206) 947-6415 Edmonds WA 98020 Project Type Nonresidential Activity Type Tenant Improvement - Change of Use Project Name: Center Annex Description of Work: Paint, carpet and floors removal of hair stations. Project Details Project Information Square Feet -Tenant Use Information Use - existing Use - proposed Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) 1,161 Was a hair salon consult offices for use by exiting business at 547 Dayton its lower level of the building Page 2 of 2