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Permit_1307650CITY OF EDMONDS Building Permit My6uildingPermitxom Permit Information Permit Number FtI r)i(li�-(1�i�1 Issued Date 5/1/2023 Expiration Date 10/28/2023 Job Address 8930 179TH PL SW Fee Paid $177.50 EDMONDS, 98026 Order Confirmation 1220212 Floor Related Permit# Suite Application ID 1307650 Contact Information Contact Name Cipriano Chavez Contractor Haider Construction Phone Number 4255772729 LNI License# HAIDEC*914DB Property Owner * ADAMS DOUGLAS A & Address 8930 179TH PL SW EDMONDS, WA Phone# 4255772729 City Bus. License # 602903374 Property Owner Phone Tenant Name Job Description A (Single Family Residential) (Re -Roof Replacement - Roofing Only) Residence project involving ( The height of the building is not increasing.) Conditions - Post Permit on site. Do not cover until inspected. 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 n9n9*i_n-*i1 Issued Date 5/1/2023 Expiration Date 10/28/2023 Job Address 8930 179TH PL SW Fee Paid $177.50 EDMONDS, 98026 Order Confirmation 1220212 Floor Related Permit# Suite Application ID 1307650 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