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BLD2023-1272+Application+10.12.2023_9.02.04_AM+3836917CITY OF EDMONDS nnyst,ilaingPermit.com Building Application #1389007 - Fire & The Feast Masonry Repair Applicant First Name Last Name Company Name Devin Greene RCA Number Street Apartment or Suite Number E-mail Address 12514 130th LN NE dgreene(D_rca-inc.com City State Zip Phone Number Extension Kirkland WA 98034 (707) 927-6921 Contractor Company Name RETAIL CONSTRUCTION ASSCTS INC Number Street Apartment or Suite Number 12514 130th LN NE City State Zip Phone Number Extension KIRKLAND WA 98034 (707) 927-6921 State License Number License Expiration Date UBI # E-mail Address RETAICA843J5 4/27/2024 603603255 dgreene(aJ_)rca-inc.com Project Location Number Street Floor Number Suite or Room Number 526 MAIN ST 1 None City Zip Code County Parcel Number EDMONDS 98020 00434212000900 Associated Building Permit Number Tenant Name BLD2020-0466 Fire & The Feast Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name ELSIA LLC Number Street Apartment or Suite Number 18411 AURORA AVE N City State Zip SHORELINE WA 98133 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: 10/12/2023 Submitted By: Devin Greene Page 1 of 2 i o CITY OF EDMONDS MyBuildingPerrnit.cm „c Building Application #1389007 - Fire & The Feast Masonry Repair Project Contact Company Name: RCA Name: Devin Greene Email: dgreene@rca-inc.com Address: 12514 130th LN NE Phone #: (707) 927-6921 Kirkland WA 98034 Project Type Nonresidential Activity Type Remodel Project Name: Fire & The Feast Masonry Repair Description of Work: Repair to an exterior wall damaged by a vehicle. Project Details Valuation Fair Market Value of Construction Work $70,000 Exterior Changes? The work involves changes to the exterior Page 2 of 2