ENP2022-0010+Application+3.10.2022_1.34.14_PM+2730415CITY OF EDMONDS MyBuildingPermit.com
Right -of -Way Application #1105737 - Anthology of Edmonds
Applicant
First Name Last Name Company Name
Michael Duqqan CA Senior Edmonds WA Property Owner LLC
Number Street Apartment or Suite Number E-mail Address
2401 E. 2nd Ave Suite 2100 mduggan(@,ca-ventures.com
city State Zip Phone Number Extension
Denver CO 80206 7208050497
Contractor
Company Name
Contractor Unknown
Number Street Apartment or Suite Number
city
State License Number
Project Location
State Zip
License Expiration Date
Number Street
city Zip Code
Associated Building Permit Number
Additional Information (i.e. equipment location or special instructions).
Work Location
Corner of 72nd and 212th
Property Owner
First Name
Number Street
City State
UBI #
County Parcel Number
Tenant Name
Last Name or Company Name
Certification Statement - The applicant states:
Zip
Phone Number Extension
E-mail Address
Floor Number Suite or Room Number
Apartment or Suite Number
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: 3/10/2022 Submitted By: Michael Duggan
Page 1 of 2
i
CITY OF EDMONDS MyBuildingPermit.com
Right -of -Way Application #1105737 - Anthology of Edmonds
Project Contact
Company Name: CA Senior Edmonds WA Property
Owner LLC
Name: Michael Duggan Email: mduggan@ca-ventures.com
Address: 2401 E. 2nd Ave Suite 2100 Phone #: 7208050497
Denver CO 80206
Project Type Activity Type Scope of Work
Multifamily Residential Encroachment Structures Permanent in Nature
Project Name: Anthology of Edmonds
Description of Work: 127 unit independent senior living community. this application is for stormwater
encroachment
Project Details
Project Information
Encroachment of private improvements
Page 2 of 2