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BLD2023-1127+Application+9.7.2023_8.11.53_AM+3767887CITY OF EDMONDS MyBuitdingPermit.com Building Application #1370262 - Mathay Ballinger Park Improvements Applicant First Name Last Name Company Name Kyle Woods City of Edmonds Number Street Apartment or Suite Number E-mail Address 700 Main Street kyle.woods(o)_edmondswa.gov City State Zip Phone Number Extension Edmonds WA 98020 (425) 599-3847 Contractor Company Name Contractor Unknown Number Street Apartment or Suite Number City State License Number Project Location State Zip License Expiration Date Number Street 24105 78TH PL W City Zip Code Edmonds 98026 Associated Building Permit Number CRA2023-0136 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Phone Number Extension UBI # E-mail Address County Parcel Number 27043100402800 Tenant Name City of Edmonds Last Name or Company Name EDMONDS CITY OF Floor Number All Suite or Room Number None Number Street Apartment or Suite Number 250 5TH AVE N City State Zip EDMONDS WA 98020-3146 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: 9/7/2023 Submitted By: Kyle Woods Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Building Application #1370262 - Mathay Ballinger Park Improvements Project Contact Company Name: CG Engineering Name: Carmel Gregory Email: carmelg@cgengineering.com Address: 250 4th Ave S Suite 200 Phone #: (425) 778-8500 Edmonds WA 98020 Project Type Activity Type Scope of Work Nonresidential New Construction Accessory Building Project Name: Mathay Ballinger Park Improvements Description of Work: New restroom and site improvements for Mathay Ballinger Park. Project Details Structure Type Accessory Structure Project Information Square Feet - Building 126 Mechanical Included? No mechanical work will occur during this project. Plumbing Included? Plumbing work will occur during this project. Page 2 of 2