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BLD2024-0533+Application+4.22.2024_8.48.38_AM+4209922CITY OF EDMONDS MyBuildingPermit.com IF Building Application #1476797 - South Hill Pain and Wellness Applicant First Name Last Name Company Name Amanda Promisloff TGB Architects Number Street Apartment or Suite Number E-mail Address 21911 76th Ave W Suite 210 apromisloff�tgbarchitects.com City State Zip Phone Number Extension Edmonds WA 98026 (425) 778-1530 Contractor Company Name Contractor Unknown Number Street Apartment or Suite Number City State License Number Project Location Number Street 21701 76TH AVE W City EDMONDS Associated Building Permit Number State Zip License Expiration Date Phone Number UBI # E-mail Address Floor Number 1 Zip Code County Parcel Number 98026 00580700002702 Tenant Name South Hill Pain and Wellness Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Number Street PO BOX 92129 Last Name or Company Name HR ACQUISITION I CORPORATION Extension Suite or Room Number Suite 104 Apartment or Suite Number City State Zip SOUTHLAKE TX 76092 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: 4/22/2024 Submitted By: Amanda Promisloff Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Building Application #1476797 - South Hill Pain and Wellness Project Contact Company Name: TGB Architects Name: Amanda Promisloff Email: apromisloff@tgbarchitects.com Address: 21911 76th Ave W Suite Phone #: (425) 778-1530 10 Edmonds WA 98026 Project Type Activity Type Nonresidential Remodel Project Name: South Hill Pain and Wellness Description of Work: Tenant improvement of and existing suite on the 1st floor including reception, waiting, exam rooms, work areas and break room Project Details Project Information Square Feet -Tenant 1,500 Valuation Fair Market Value of Construction Work $262,500 Exterior Changes? The work does not involve changes to the exterior Page 2 of 2