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Application_1307650CITY OF EDMONDS MyBuildingPermit.com Building Application #1307650 Applicant First Name Last Name Company Name Cipriano Chavez Haider Construction Number Street Apartment or Suite Number E-mail Address 5607 244th St. SW cipriano@haiderconstruction.com City State Zip Phone Number Extension Mountlake Terrace WA 98043 (425) 577-2729 Contractor Company Name Haider Construction Number Street Apartment or Suite Number 5607 244th St. SW City State Zip Phone Number Extension Mountlake Terrace WA 98043 4255772729 State License Number License Expiration Date UBI # E-mail Address HAIDEC*914DB 4/7/2025 RDggDi.174 cipriano@haiderconstruction.com Project Location Number Street Floor Number Suite or Room Number 8930 179TH PL SW City Zip Code County Parcel Number EDMONDS 98026 00459000001100 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 * ADAMS DOUGLAS A & COURTNEY C Number Street Apartment or Suite Number 8930 179TH PL SW 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: 5/1/2023 Submitted By: Cipriano Chavez Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1307650 Project Type Single Family Residential Project Details Increasing Building Height? Activity Type Scope of Work Re -Roof Replacement - Roofing Only Residence The height of the building is not increasing. Page 2 of 2