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Application_2022-0485CITY OF EDMONDS MyBuildingPermit.com Building Application #1125906 Applicant First Name Last Name Company Name TAKUMI MIZUKOSHI Number Street Apartment or Suite Number E-mail Address 9122 Olympic View Drive takumi.mizukoshi0400@gmail.com City State Zip Phone Number Extension EDMONDS WA 98026 2064919337 Contractor Company Name Owner Number Street Apartment or Suite Number City State Zip Phone Number Extension State License Number License Expiration Date UBI # E-mail Address Project Location Number Street Floor Number Suite or Room Number 9122 OLYMPIC VIEW DR City Zip Code County Parcel Number EDMONDS 98026 27041800203800 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 Takumi Mizukoshi Number Street Apartment or Suite Number 9122 OLYMPIC VIEW DR 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: 4/18/2022 Submitted By: TAKUMI MIZUKOSHI Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1125906 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