BLD2022-1493+Application+10.31.2022_11.06.30_AM+3193814RECEIVED BLD2022-1493
Oct 31 2022 / CITY OF EDMONDS CITY OF EDMONDS MyBuitdingPermit.com
- DEVELOPMENT SERVICES
DEPARTMENT
Special Use or Event Application #1223134 - Red Barn Event
Applicant
First Name Last Name Company Name
Brad Shipley
Number Street Apartment or Suite Number E-mail Address
121 5th Ave N brad. shipley(�Dedmondswa.gov
City State Zip Phone Number Extension
Edmonds WA 98020 (425) 967-2645
Contractor
Company Name
Number Street Apartment or Suite Number
City State Zip Phone Number Extension
State License Number License Expiration Date UBI # E-mail Address
Project Location
Number Street Floor Number Suite or Room Number
228 5TH AVE S
City Zip Code County Parcel Number
EDMONDS 98020 27032300408000
Associated Building Permit Number Tenant Name
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
First Name Last Name or Company Name
JIM BOB INVESTMENTS LLC
Number Street Apartment or Suite Number
234 5TH AVE S
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: 10/31/2022 Submitted By: Brad Shipley
Page 1 of 2
CITY OF EDMONDS MyBuildingPermit.com
Special Use or Event Application #1223134 - Red Barn Event
Project Contact
Company Name:
Name:
Address:
Project Type
Any Project Type
Brad Shipley
121 5th Ave N
Edmonds WA 98020
Email: brad.shipley@edmondswa.gov
Phone #: (425) 967-2645
Activity Type
Special Use
Project Name: Red Barn Event
Description of Work: Temp use of vacant structure for city host event
Project Details
Event Location
Private Property
Event Date
Begin Date 11/5/2022
End Date 11/5/2022
Scope of Work
Outdoor Seating
Page 2 of 2