Permit_1182133CITY OF EDMONDS
Building Permit
My6uildingPermitxom
Permit Information
Permit Number
RI ngngq-1 nqq Issued Date
8/2/2022
Expiration Date
1/29/2023
Job Address
21110 SHELL VALLEY RD Fee Paid
$146.50
EDMONDS, 98026 Order Confirmation
1163553
Floor
Related Permit#
Suite
Application ID
1182133
Contact Information
Contact Name
Jacob Smith Contractor
VALENTINE ROOFING INC
Phone Number
(206) 575-7807
Property Owner
Robert A &Jimenez Gladys A LNI License#
VALENRI927J8
Address
16631 SE 15TH ST BELLEVUE, WA Phone#
(206) 575-7807
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: Jacob Smith
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1893
CITY OF EDMONDS
Building Permit
My6uildingPermitxom
Permit Information
Permit Number
RI n9n99_ingg
Issued Date
8/2/2022
Expiration Date
1 /29/2023
Job Address
21110 SHELL VALLEY RD
Fee Paid
$146.50
EDMONDS, 98026
Order Confirmation
1163553
Floor
Related Permit#
Suite
Application ID
1182133
Inspections
Inspection IVR Inspector Date Inspection
IVR Inspector Date
Tear Off or Sheathing
Building Final
Inspection Scheduling
The issuance of this permit in no way constitutes approval from any other agencies having regulatory authority over
the facility and this construction activity. It is the responsibility of the property owner
to obtain any and all such
required approvals.
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