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Application_1210230CITY OF EDMONDS MyBuildingPermit.com Building Application #1210230 Applicant First Name Last Name cipriano chavez Company Name Haider Construction Number Street 5607 244th St. SW Apartment or Suite Number E-mail Address cipriano@haiderconsturction.com City State Zip Mountlake Terrace WA 98043 Phone Number Extension (425) 577-2729 Contractor Company Name Haider Construction Number Street 5607 244th St. SW Apartment or Suite Number City State Zip Mountlake Terrace WA 98043 Phone Number Extension 4255772729 State License Number License Expiration Date HAIDEC*914DB 4/7/2023 UBI # E-mail Address BDggD:.174 cipriano@haiderconstruction.com Project Location Number Street 8822 216TH ST SW Floor Number Suite or Room Number City Zip Code EDMONDS 98026 County Parcel Number 00602600000500 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 Lesley Miller Number Street 8822 216TH ST SW Apartment or Suite Number City State EDMONDS WA Zip 98026-7844 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: 10/3/2022 Submitted By: cipriano chavez Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1210230 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