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BLD2023-1453+Application+11.14.2023_11.14.48_AM+3899020CITY OF EDMONDS Building Application #1393767 - Bracket B101 Applicant First Name Last Name lance barkman Number Street Apartment or Suite Num 21522 84th ave s City State Zip kent WA 76137 Contractor Company Name INTERSTATE RESTORATION WA LLC Number Street 3401 QUORUM DR SUITE 300 City State Zip FORT WORTH TX 76137 State License Number License Expiration Date UBI # INTERRW905BH 1/12/2024 602846667 Project Location MyBuildingPermit.com Company Name interstate Restoration or E-mail Address lance. barkman(cD_firstonsite.com Phone Number Extension (206) 604-7173 Apartment or Suite Number Phone Number Extension (817) 293-0035 E-mail Address lance. barkman(cD_firstonsite.corn Number Street Floor Number Suite or Room Number 9501 244TH ST SW B101 City Zip Code County Parcel Number EDMONDS 98020 27033600403800 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 US REIF FIRDALE VILLAGE WASHINGTON LLC Number Street Apartment or Suite Number 10100 SANTA MONICA BLVD 400 City State Zip LOS ANGELES CA 90067 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: 11/14/2023 Submitted By: lance barkman Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1393767 - Bracket B101 Project Contact Company Name: interstate Restoration Name: lance barkman Email: lance.barkman@firstonsite.com Address: 21522 84th ave s Phone #: (206) 604-7173 kent WA 76137 Project Type Single Family Condominium Unit Activity Type Remodel Project Name: Bracket B101 Description of Work: Replace damaged framing as prescribed in engineer report. Project Details Primary Use Residential Apartments Valuation Fair Market Value of Construction Work Exterior Changes? The work does not involve changes to the exterior Contact Information Owner Email Address $9,900 pm.brackett@avenue5apt.com Page 2 of 2