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Application_1015753CITY OF EDMONDS MyBuildingPermit.com Building Application #1015753 Applicant First Name Cipriano Last Name Chavez Company Name Haider Remodeling & Roofing LLC Number Street 5607 244th St SW Apartment or Suite Number E-mail Address cipriano@haiderconstruction.com City State Mountlake Terrace WA Zip 98043 Phone Number Extension 4255772729 Contractor Company Name Haider Construction Number Street 5607 244th St SW Apartment or Suite Number City Mountlake Terrace State Zip WA 98043 Phone Number Extension 4255772729 State License Number HAIDEC*914DB License Expiration Date UBI # 4/7/2023 BDggD:.174 E-mail Address cipriano@haiderconstruction.com Project Location Number Street 23626 84TH AVE W Floor Number Suite or Room Number City EDMONDS Zip Code County Parcel Number 98026 00463300100101 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name *Ashley and Tim Last Name or Company Name Bischoff Number Street 23626 84th Ave W Apartment or Suite Number City EDMONDS State Zip WA 98026 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: 9/7/2021 Submitted By: Cipriano Chavez Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1015753 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