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Application_1017065CITY OF EDMONDS MyBuildingPermit.com Building Application #1017065 Applicant First Name Last Name Reid Larson Company Name Number Street 21818 95th Ave W Apartment or Suite Number E-mail Address schoonover.larson@gmail.com City State Zip Edmonds WA 98020 Phone Number Extension 2065956033 Contractor Company Name addicott roofing inc Number Street 18926 83rd ave west Apartment or Suite Number City State Zip edmonds WA 98026 Phone Number Extension (425) 774-0806 State License Number License Expiration Date ADDICI*219JT 5/10/2022 UBI # E-mail Address RDD9A9gR7 rod@addicottroofing.com Project Location Number Street 21818 95TH AVE W Floor Number Suite or Room Number City Zip Code EDMONDS 98020 County Parcel Number 00527900001200 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 Reid A Larson Number Street 21818 95TH AVE W Apartment or Suite Number City State EDMONDS WA Zip 98020-3914 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: 9/9/2021 Submitted By: Reid Larson Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1017065 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