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FIR2023-0030+Application+4.4.2023_10.28.11_AM+3461713CITY OF EDMONDS MyBuildingPermit.com Fire Application #1293525 - 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 (503) 952-1563 Contractor Company Name Contractor Unknown Number Street Apartment or Suite Number City State License Number Project Location State Zip License Expiration Date UBI # Number Street 21200 72ND AVE W City Zip Code County Parcel Number EDMONDS 98026 00580700000401 Associated Building Permit Number Tenant Name BLD2021-0088 Vacant Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Phone Number Extension E-mail Address Floor Number Suite or Room Number GARAGE P1, none First Name Last Name or Company Name CA SENIOR EDMONDS WAS PROPERTY OWNER LLC Number Street Apartment or Suite Number PO BOX 92129 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: 4/4/2023 Submitted By: Richard Grimes Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Fire Application #1293525 - 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 #: (503) 952-1563 Portland OR 97209 Project Type Activity Type Scope of Work Multifamily Residential New Smoke Control System Project Name: Anthology of Edmonds Senior Living Description of Work: Smoke control design for ongoing project in construction. Project Details Other Building Permit # BLD2021-0088 Type of Work Smoke Control System Smoke Control Work The smoke control work is not in association with a tenant improvement Page 2 of 2