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FIR2022-0099+Application+9.16.2022_11.37.28_AM+3113048CITY OF EDMONDS MyBuitdingPermit.com IF Special Use or Event Application #1203122 - Celebrate! Applicant First Name Last Name Company Name Charlotte Dahlman CORT Party Rental Number Street Apartment or Suite Number E-mail Address 6101 Associated Blvd Suite 102 charlotte.dahlman(LDcort.com City State Zip Phone Number Extension Everett WA 98203 (425) 903-8158 Contractor Company Name Number Street City State License Number Project Location State Zip License Expiration Date Number Street 410 4TH AVE N City Zip Code EDMONDS 98020 Associated Building Permit Number #147551 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Apartment or Suite Number Phone Number Extension UBI # E-mail Address Floor Number Suite or Room Number County Parcel Number 27032400207100 Tenant Name Last Name or Company Name EDMONDS PUBLIC FACILITIES DISTRICT Number Street Apartment or Suite Number 121 5TH AVE N City State Zip EDMONDS WA 98020 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: 9/16/2022 Submitted By: Charlotte Dahlman Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Special Use or Event Application #1203122 - Celebrate! Project Contact Company Name: CORT Party Rental Name: Charlotte Dahlman Email: charlotte.dahlman@cort.com Address: 6101 Associated Blvd Suite Phone #: (425) 903-8158 102 Everett WA 98203 Project Type Activity Type Scope of Work Any Project Type Special Use Outdoor Seating Project Name: Celebrate! Description of Work: Building a 20x30 Kitchen Tent for Edmonds Center For the Arts Annual Event: Celebrate! Project Details Event Location Private Property Event Date Begin Date 9/20/2022 End Date 9/24/2022 Page 2 of 2