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Application_BLD2023-0585CITY OF EDMONDS MyBuildingPermit.com Building Application #1315291 Applicant First Name Aza Last Name Company Name Cline Mountain GoatRoofing Number Street 0278 Apartment or Suite Number E-mail Address mgroofs@yahoo.com City State Lynnwood WA Zip Phone Number Extension 98046-0278 (206) 841-1645 Contractor Company Name Mountain Goat Roofing Number Street 0278 Apartment or Suite Number City Lynnwood State Zip Phone Number Extension WA 98046-0278 (206) 625-0190 State License Number MOUNTGR025D7 License Expiration Date UBI # E-mail Address 6/25/2024 FD1774667 mgroofs@yahoo.com Project Location Number Street 18303 76TH AVE W Floor Number Suite or Room Number City EDMONDS Zip Code County Parcel Number 98026 00370800300601 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Bruce P Last Name or Company Name Gothard Number Street 18303 76TH AVE W Apartment or Suite Number City EDMONDS State Zip 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: 5/13/2023 Submitted By: Aza Cline Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1315291 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