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BLD2021-0088+Application+1.23.2021_11.12.40_AM+2005563CITY OF EDMONDS MyBuitdingPermit.com Building Application #908561 - Anthology of Edmonds Senior Living Applicant First Name Last Name Company Name Mark Miller Ankrom Moisan Architects Number Street Apartment or Suite Number E-mail Address 38 NW Davis St 300 markcm(c_ankrommoisan.com City State Zip Phone Number Extension Portland OR 97209 5039521397 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 206.915.0904 State License Number License Expiration Date UBI # E-mail Address GRAHACM954CG 9/18/2021 602136692 richardq(a_ankrommoisan.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 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: 1/23/2021 Submitted By: Mark Miller Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Building Application #908561 - Anthology of Edmonds Senior Living Project Contact Company Name: Ankrom Moisan Architects Name: Richard Grimes Email: richardg@ankrommoisan.com Address: 8 NW Davis St NW Davis Phone #: 5039521563 Portland OR 97209 Project Type Activity Type Scope of Work Mixed Use New Construction Primary Building Project Name: Anthology of Edmonds Senior Living Description of New grounds up construction. Facility will house 127 independent units. In house dining will Work: be provide along with activity space for resident use, including but not limited to community room, dining room, salon and a gym. Project Details Project Information IBC Occupancy type Construction Type VA over IA VA Sprink Sub R-2, A, B, S-1, S-2 Page 2 of 2