Permit_2021-1085CITY OF EDMONDS
Building Permit
My6uildingPermitxom
Permit Information
Permit Number
RI n9ing1 _1 nw; Issued Date
8/5/2021
Expiration Date
2/1 /'2022
Job Address
23632 101 STAVE W Fee Paid
$150.90
EDMONDS, 98020 Order Confirmation
1082584
Floor
Related Permit#
Suite
Application ID
1001773
Contact Information
Contact Name
Ann Dvorak Contractor
VALENTINE ROOFING INC
Phone Number
2064007151
LNI License#
VALENRI927J8
Property Owner
Gary G Sayers
Address
23632 101STAVE W EDMONDS, Phone#
2064007151
WA City Bus. License#
VALENRI927J8
Property Owner Phone
Tenant Name
Job Description
A (Single Family Residential) (Re -Roof Replacement - Roofing & Sheathing) Residence project involving ( The height of
the building is not increasing.)
Conditions - Post Permit on site. Do not cover until inspected.
Do not start any work until the preconstruction meeting is completed.
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.
Applicant: Ann Dvorak
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CITY OF EDMONDS
Building Permit
My6uildingPermitxom
Permit Information
Permit Number
RI n9ng 1-i nR-1;
Issued Date
8/5/2021
Job Address
23632 101 ST AVE W
Expiration Date
2/1/2022
Fee Paid
$150.90
EDMONDS, 98020
Order Confirmation
1082584
Floor
Related Permit#
Suite
Application ID
1001773
Inspections
Inspection IVR Inspector Date Inspection
IVR Inspector Date
Tear Off or Sheathing
Building Final
Inspection Scheduling
(425) 771-0220 or www.MyBuildingPermit.com
❑�❑�
r
Subject to any and all conditions as listed on Page 1 of this document.
Re -inspection fees may apply if work is not ready for a requested inspection.
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Follow the jurisdiction's construction hours and noise restrictions.
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