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Application_1259149CITY OF EDMONDS MyBuildingPermit.com Building Application #1259149 Applicant First Name Last Name Company Name Steven Kelly Number Street Apartment or Suite Number E-mail Address 21926 83rd AVE W bettkaffer@yahoo.com City State Zip Phone Number Extension Edmonds WA 98026 (858) 663-8355 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 21926 83RD AVE W City Zip Code County Parcel Number EDMONDS 98026 00541100000100 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 Steven Kelly Number Street Apartment or Suite Number 21926 83rd Ave W City State Zip Edmonds Washington 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: 1/25/2023 Submitted By: Steven Kelly Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1259149 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