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Application_1054659CITY OF EDMONDS MyBuildingPermit.com Building Application #1054659 Applicant First Name Last Name Company Name Camilo Zambrano Edca Inc Number Street Apartment or Suite Number E-mail Address 1016 Industry Drive camilo@edcaroofing.com City State Zip Phone Number Extension Tukwila WA 98188 (206) 762-7294 Contractor Company Name Edca Inc Number Street Apartment or Suite Number 1016 Industry Drive City State Zip Phone Number Extension Tukwila WA 98188 (206) 762-7294 State License Number License Expiration Date UBI # E-mail Address edcai**126rt 1 /6/2023 FD 1 1'19F;4s camilo@edcaroofing.com Project Location Number Street Floor Number Suite or Room Number 17925 72ND AVE W City Zip Code County Parcel Number EDMONDS 98026 00513100016017 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 Kenneth S & Krista L Galloway Number Street Apartment or Suite Number 17925 72ND AVE W City State Zip EDMONDS 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: 11/23/2021 Submitted By: Camilo Zambrano Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1054659 Project Type Single Family Residential Project Details Increasing Building Height? Activity Type Scope of Work Re -Roof Replacement - Roofing Only Residence The height of the building is not increasing. Page 2 of 2