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Application_BLD2023-0316CITY OF EDMONDS MyBuildingPermit.com Building Application #1282232 Applicant First Name Last Name Company Name Julia Inozemtseva Number Street Apartment or Suite Number E-mail Address 20709 77th PI W jinozemtseva@gmail.com City State Zip Phone Number Extension Edmonds WA 98026 (609) 240-9734 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 20709 77TH AVE W City Zip Code County Parcel Number EDMONDS 98020 00595800001600 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 Stanislav & Julia Inozemtseva Malov Number Street Apartment or Suite Number 20709 77th PI W City State Zip Edmonds WA 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: 3/13/2023 Submitted By: Julia Inozemtseva Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1282232 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