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Permit_1017065CITY OF EDMONDS Building Permit My6uildingPermitxom Permit Information Permit Number RI f17f171 _17_(1 Issued Date 9/9/2021 Expiration Date 3/8/2022 Job Address 21818 95TH AVE W Fee Paid $150.90 EDMONDS, 98020 Order Confirmation 1089586 Floor Related Permit# Suite Application ID 1017065 Contact Information Contact Name Rod Addicott Contractor addicott roofing inc Phone Number (425) 774-0806 Property Owner Reid A Larson LNI License# ADDICI*219JT Address 21818 95TH AVE W EDMONDS, WA Phone# (425) 774-0806 City Bus. License # 600292967 Property Owner Phone 2065956033 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: Reid Larson Page 1 of 2 CITY OF EDMONDS Building Permit My6uildingPermitxom Permit Information Permit Number RI n9n91_19_f1 Issued Date 9/9/2021 Job Address 21818 95TH AVE W Expiration Date 3/8/2022 Fee Paid $150.90 EDMONDS, 98020 Order Confirmation 1089586 Floor Related Permit# Suite Application ID 1017065 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. �■ Follow the jurisdiction's construction hours and noise restrictions. Page 2 of 2