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ENG2022-0038+Application+2.2.2022_9.10.53_AM+2656252CITY OF EDMONDS MyBuildingPermit.com IF Right -of -Way Application #1082564 - Anthology Senior Living Applicant First Name Last Name Company Name Mike Parker CADB CATALYST CNSTRCTN GRP LLC Number Street Apartment or Suite Number E-mail Address 130 E Randolph St 201 mparker(aD_catalystconstructiongrp.com City State Zip Phone Number Extension Chicaqo IL 60601 13127672531 Contractor Company Name CADB CATALYST CNSTRCTN GRP LLC Number Street Apartment or Suite Number 130 E RANDOLPH ST, SUITE 2100 City State Zip Phone Number Extension CHICAGO IL 60601 3127672531 State License Number License Expiration Date UBI # E-mail Address CADBCCC801 PR 10/28/2022 604519175 mparker(cD_catalystconstructiongrp.com Project Location Number Street 21200 72ND AVE W City Zip Code EDMONDS 98026 Associated Building Permit Number BLD2021-0088 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name County Parcel Number 00580700000401 Tenant Name Anthology Last Name or Company Name JAS GROUP LLC Floor Number Suite or Room Number 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: 2/2/2022 Submitted By: Mike Parker Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Right -of -Way Application #1082564 - Anthology Senior Living Project Contact Company CADB CATALYST Name: CNSTRCTN GRP LLC Name: Alex Kushner Email: akushner@catalystconstructiongrp.com Address: 130 E Randolph St 201 Phone #: (206)900-2395 Chicago IL 60601 Project Type Activity Type Scope of Work Nonresidential New Excavation and Utility Work Project Name: Anthology Senior Living Description of Work: Frontage improvements & utility work associated with the Anthology Senior Living Project Project Details Project Information Utility Service Installation Impervious Surface Adding/Replacing 2,000 square feet or more of hard surface Clearing and Grading Information This is new development Tree Removal There are five or less significant trees to be removed Page 2 of 2