FIR2023-0068+Application+7.17.2023_2.10.44_PM+3669577CITY OF EDMONDS
Fire Application #1348006 - XANTHOSL01
Applicant
First Name Last Name
Deborah Mitchell
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MyBuitdingPermit.com
Company Name
CTS
Number Street Apartment or Suite Number E-mail Address
2720 South Ash Street
City State Zip
Tacoma WA 98409
Contractor
Company Name
CTS
Number Street
2720 South Ash Street
City State Zip
Tacoma WA 98409
State License Number License Expiration Date UBI #
CTS"*TS881 BK 1/12/2024 602970115
Project Location
Number Street
21200 72ND AVE W
deborahm(D,cablects.com
Phone Number Extension
(206) 686-2000 138
Apartment or Suite Number
Phone Number Extension
(206) 686-2000
E-mail Address
deborahm(c_cablects.com
Floor Number Suite or Room Number
ALL NONE
City Zip Code County Parcel Number
EDMONDS 98026 00580700000401
Associated Building Permit Number Tenant Name
Anthology Senior Livinq
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
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: 7/17/2023 Submitted By: Deborah Mitchell
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CITY OF EDMONDS MyBuildingPermit.com
Fire Application #1348006 - XANTHOSL01
Project Contact
Company Name: CTS
Name: Deborah Mitchell Email: deborahm@cablects.com
Address: 2720 South Ash Street Phone #: (206) 686-2000 138
Tacoma WA 98409
Project Type
Nonresidential
Activity Type
Alteration
Project Name: XANTHOSL01
Description of Work: Distributed antenna system
Project Details
Valuation
Fair Market Value of Work
Type of Work
Emergency Radio Coverage System
Panel or Power Supply
The work does not involve a new fire alarm panel or
power supply
Contact Information
Owner Email Address
Scope of Work
Fire Alarm
$61,100
information@anthologyseniorliving.com
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