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BLD2024-0584+Application+5.2.2024_9.03.42_AM+4232616CITY OF EDMONDS Building Application #1482387 - LCNW Applicant First Name Last Name Amanda Promisloff i MyBuitdingPermit.com Company Name TGB Architects Number Street Apartment or Suite Number E-mail Address 21911 76th Ave W Suite 210 apromisloff antgbarchitects.com City State Zip Edmonds WA 98026 Contractor Company Name Contractor Unknown Number Street City State License Number Project Location Number Street 21616 76TH AVE W City EDMONDS Associated Building Permit Number State Zip License Expiration Date UBI # Phone Number Extension (425) 778-1530 Zip Code County Parcel Number 98026 00461000100102 Tenant Name LCNW Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Number Street PO BOX 92129 Apartment or Suite Number Phone Number Extension E-mail Address Floor Number Suite or Room Number 1 111 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: 5/2/2024 Submitted By: Amanda Promisloff Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1482387 - LCNW 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 Remodel Project Name: LCNW Description of Work: Minor demolition and finishes upgrade throughout the suite Project Details Project Information Square Feet -Tenant 1,146 Valuation Fair Market Value of Construction Work $120,000 Exterior Changes? The work does not involve changes to the exterior Page 2 of 2