Permit_1119603CITY OF EDMONDS
Building Permit
My6uildingPermitxom
Permit Information
Permit Number
RI ngngq_na�7 Issued Date
4/5/2022
Expiration Date
1 0/2/2022
Job Address
18603 81 ST AVE W Fee Paid
$146.50
EDMONDS, 98026 Order Confirmation
1134299
Floor
Related Permit#
Suite
Application ID
1119603
Contact Information
Contact Name
Ann Dvorak Contractor
VALENTINE ROOFING INC
Phone Number
2065757656
LNI License#
VALENRI927J8
Property Owner
Theodore F Haase
Address
18603 81ST AVE W EDMONDS, WA Phone#
2065757656
City Bus. License#
VALENRI927J8
Property Owner Phone
Tenant Name
Job Description
A (Single Family Residential) (Re -Roof Replacement - Roofing Only) 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: Ann Dvorak
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CITY OF EDMONDS
Building Permit
My6uildingPermitxom
Permit Information
Permit Number
RI ngngq-nA*17
Issued Date
4/5/2022
Expiration Date
1 0/2/2022
Job Address
18603 81 ST AVE W
Fee Paid
$146.50
EDMONDS, 98026
Order Confirmation
1134299
Floor
Related Permit#
Suite
Application ID
1119603
Inspections
Inspection IVR Inspector Date Inspection
IVR Inspector Date
Tear Off or Sheathing
Building Final
Inspection Scheduling
Go to: www.MyBuildingPermit.com or call (425) 771-0220.
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