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BLD2024-0285+Application+3.1.2024_11.00.53_AM+4095616CITY OF EDMONDS MyBuitdingPermit.com Building Application #1450839 - Conference Room/Staff Support Applicant First Name Last Name Company Name Karsea Lanqlois Insiqht Desiqn Studio Number Street Apartment or Suite Number E-mail Address 12345 Lake City Way NE #2108 karsea(cb_insightarch.us City State Zip Phone Number Extension Seattle WA 98125 (206) 601-6645 Contractor Company Name MY -WAY CONSTRUCTION LLC Number Street Apartment or Suite Number 12345 Lake City Way NE #2108 City State Zip Phone Number Extension Seattle WA 98125 (206) 601-6645 State License Number License Expiration Date UBI # E-mail Address MYWAYCL913P3 10/26/2025 602958832 karseaCcDinsightarch.us Project Location Number Street Floor Number Suite or Room Number 7315 212TH ST SW 1 and 2 None City Zip Code County Parcel Number EDMONDS 98026 00566900500600 Associated Building Permit Number Tenant Name Virqinia Mason Franciscan Health Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name GAHC4 EDMONDS WA MOB LLC Number Street Apartment or Suite Number 18191 VON KARMAN AVE City State Zip IRVINE CA 92612 Certification Statement - The applicant states: 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. 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: 3/1/2024 Submitted By: Karsea Langlois Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Building Application #1450839 - Conference Room/Staff Support Project Contact Company Name: Insight Design Studio Name: Karsea Langlois Email: karsea@insightarch.us Address: 12345 Lake City Way NE #2108 Phone #: (206) 601-6645 Seattle WA 98125 Project Type Nonresidential Activity Type Remodel Project Name: Conference Room/Staff Support Description of Work: A remodel to create a staff conference room and soiled holding room (for soiled linens) on the 1st floor, and modifications to the existing staff lounge on the 2nd floor. Project Details Project Information Square Feet -Tenant 1,403 Valuation Fair Market Value of Construction Work $120,000 Exterior Changes? The work does not involve changes to the exterior Page 2 of 2