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BLD2024-0847+Application+6.26.2024_3.41.35_PM+4345824CITY OF EDMONDS MyBuitdingPermit.com Building Application #1505782 - Healthcare Realty Transformation Care Network 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(a�tgbarchitects.com City State Zip Phone Number Extension Edmonds WA 98026 (425) 778-1530 Contractor Company Name AXIOM NORTHWEST CONST INC Number Street Apartment or Suite Number 2232 Broadway 101 City State Zip Phone Number Extension Everett WA 98201 (425) 903-4038 State License Number License Expiration Date UBI # E-mail Address AXIOMNC920LJ 7/28/2024 602838426 ryan(a)axiomnw.com Project Location Number Street Floor Number Suite or Room Number 21701 76TH AVE W 3 300 City Zip Code County Parcel Number EDMONDS 98026 00580700002702 Associated Building Permit Number Tenant Name Transformation Care Network 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 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: 6/26/2024 Submitted By: Amanda Promisloff Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1505782 - Healthcare Realty Transformation Care Network Project Contact Company Name: TGB Architects Name: Amanda Promisloff Email: apromisloff@tgbarchitects.com Address: 21911 76th Ave W Suite Phone #: (425) 778-1530 Edmonds WA 98026 Project Type Nonresidential Activity Type Tenant Improvement Project Name: Healthcare Realty Transformation Care Network Description of Work: remodel of existing suites 300A, 300B, and 306 into one suite, work to include a new reception and waiting and offices for patient care Project Details Project Information Square Feet -Tenant 4,790 Use Information Use - existing b-business Use - proposed b-business Work Location Work Description/Location (example: 1 st floor, suite 300, third floor Master Bath, Garage) Valuation Fair Market Value of Construction Work $300,000 Exterior Changes? The work does not involve changes to the exterior Page 2 of 2