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Application_2021-1048CITY OF EDMONDS MyBuildingPermit.com Building Application #998071 Applicant First Name Last Name Remik Rybienik Company Name Alfa Roofing Number Street 24226 77th Place West Apartment or Suite Number E-mail Address rybienik@alfaroofing.com City State Zip Edmonds WA 98026 Phone Number Extension (425) 673-9020 Contractor Company Name Alfa Roofing Number Street 24226 77th Place West Apartment or Suite Number City State Zip Edmonds WA 98026 Phone Number Extension (425) 673-9020 425 750-0839 State License Number License Expiration Date ALFAR**044KA 1/29/2022 UBI # E-mail Address RD17Df1957 rybienik@alfaroofing.com Project Location Number Street 811 SOMERSET LN Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00639700000400 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 F June Schaertl Number Street 811 SOMERSET LANE Apartment or Suite Number City State EDMONDS WA Zip 98020 Certification Statement - The applicant states: I certify that I am the owner of this property or the owner's authorized agent, including an appropriately licensed contractor. I have furnished true and correct information. I will comply with all provisions of law and ordinances governing this type of construction work, whether specific herein or not. By submitting this application I give the jurisdiction permission to enter the property to perform inspections. I understand that failure to comply with the above may result in revocation of the permit. Date Submitted: 7/29/2021 Submitted By: Remik Rybienik Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #998071 Project Type Single Family Residential Project Details Increasing Building Height? Activity Type Scope of Work Re -Roof Replacement - Roofing & Sheathing Residence The height of the building is not increasing. Page 2 of 2