Permit_1181966CITY OF EDMONDS
Building Permit
My6uildingPermitxom
Permit Information
Permit Number
RI ngngq_1 n9A Issued Date
8/3/2022
Expiration Date
1/30/2023
Job Address
20112 81 ST AVE W Fee Paid
$146.50
EDMONDS, 98026 Order Confirmation
1163432
Floor
Related Permit#
Suite
Application ID
1181966
Contact Information
Contact Name
Cipriano Chavez
Contractor
Haider Construction
Phone Number
4255772729
Property Owner
James G & Marie E Dubois LNI License#
HAIDEC*914DB
Address
20112 81ST AVE W EDMONDS, WA Phone#
4255772729
City Bus. License #
602903374
Property Owner Phone
Tenant Name
Job Description
A (Single Family Residential) (Re -Roof Replacement - Roofing & Sheathing) 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: cipriano chavez
Page 1 of 2
t °F EDAf
0
1893
CITY OF EDMONDS
Building Permit
My6uildingPermitxom
Permit Information
Permit Number
RI n9n99_1n9A
Issued Date
8/3/2022
Expiration Date
1 /30/2023
Job Address
20112 81 ST AVE W
Fee Paid
$146.50
EDMONDS, 98026
Order Confirmation
1163432
Floor
Related Permit#
Suite
Application ID
1181966
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.
Page 2 of 2