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Application_1211503CITY OF EDMONDS MyBuildingPermit.com Building Application #1211503 Applicant First Name Last Name Jacob Smith Company Name Valentine Roofing Inc. Number Street 400 Industry Drive Apartment or Suite Number E-mail Address #130 projectengineers@valentineroof.com City State Zip Tukwila WA 98188 Phone Number Extension (206) 575-7656 Contractor Company Name VALENTINE ROOFING INC Number Street 910 Industry Drive Apartment or Suite Number City State Zip Tukwila WA 98188 Phone Number Extension (206) 575-7807 State License Number License Expiration Date VALENR1927J8 4/28/2024 UBI # E-mail Address RD9R1g179 projectengineers@valentineroof.com Project Location Number Street 21308 84TH AVE W Floor Number Suite or Room Number City Zip Code EDMONDS 98026 County Parcel Number 00613400000900 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 Eliass & Lisa Alfi Number Street 21308 84TH AVE W Apartment or Suite Number City State EDMONDS WA Zip 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: 10/5/2022 Submitted By: Jacob Smith Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1211503 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