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BLD2021-0756+Application+6.2.2021_1.23.02_PM+2228254CITY OF EDMONDS MyBuitdingPermit.com Mechanical Application #970773 - Anthology of Edmonds Senior Living Applicant First Name Last Name Company Name Richard Grimes Ankrom Moisan Architects Number Street Apartment or Suite Number E-mail Address 38 NW Davis St 300 richardq(abankrommoisan.com City State Zip Phone Number Extension Portland OR 97209 5039521563 Contractor Company Name GRAHAM CONST & MANAGEMENT INC Number Street Apartment or Suite Number 568 1 st ave s. 400 City State Zip Phone Number Extension Seattle WA 98104 206-561-3500 State License Number License Expiration Date UBI # E-mail Address GRAHACM954CG 9/18/2021 602136692 losh.koehler(D_grahamus.com Project Location Number Street Floor Number Suite or Room Number 21200 72ND AVE W All none City Zip Code County Parcel Number EDMONDS 98026 00580700000401 Associated Building Permit Number Tenant Name BLD2021-0088 CA Senior Livinq Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name JAS GROUP LLC Number Street Apartment or Suite Number 154 LAKE WASHINGTON BLVD E City State Zip SEATTLE WA 98112 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: 6/2/2021 Submitted By: Richard Grimes Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Mechanical Application #970773 - Anthology of Edmonds Senior Living Project Contact Company Name: Ankrom Moisan Architects Name: Richard Grimes Email: richardg@ankrommoisan.com Address: 38 NW Davis St 300 Phone #: 5039521563 Portland OR 97209 Project Type Nonresidential Activity Type New Scope of Work Mechanical Project Name: Anthology of Edmonds Senior Living Description of Work: New ground up senior living facility, with resident unit, a commercial kitchen and resident common areas. Project Details Scope of Work Mech Equipment Per Plans Work Location Work Description/Location (example: 1 st floor, HVAC systems for a new ground up building. Scope Master Bath, Garage) affects all levels of building, see plans for unit layouts and equipment schedules. Page 2 of 2