Application_2021-1312CITY OF EDMONDS MyBuildingPermit.com
Building Application #1024832
Applicant
First Name Last Name
Ann Dvorak
Company Name
Valentine Roofing Inc.
Number Street
400 Industry Drive
Apartment or Suite Number E-mail Address
#130 ann@valentineroof.com
City State Zip
Tukwila WA 98188
Phone Number Extension
2065757656
Contractor
Company Name
VALENTINE ROOFING INC
Number Street
400 Industry Drive
Apartment or Suite Number
#130
City State Zip
Tukwila WA 98188
Phone Number Extension
2065757656
State License Number License Expiration Date
VALENR1927J8 4/28/2022
UBI # E-mail Address
RD9R1g179 ann@valentineroof.com
Project Location
Number Street
7107 177TH ST SW
Floor Number Suite or Room Number
City Zip Code
EDMONDS 98026
County Parcel Number
00719300000400
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
Holly G Hudson
Number Street
7107 177TH ST SW
Apartment or Suite Number
City State
EDMONDS WA
Zip
98026-5621
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: 9/24/2021 Submitted By: Ann Dvorak
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CITY OF EDMONDS MyBuildingPermit.com
Building Application #1024832
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.
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