Permit_1319851CITY OF EDMONDS
Building Permit
My6uildingPermitxom
Permit Information
Permit Number
RI ngnq�_nsgn Issued Date
5/22/2023
Expiration Date
11/18/2023
Job Address
16123 MEADOWDALE RD Fee Paid
$177.50
EDMONDS, 98026 Order Confirmation
1225582
Floor
Related Permit#
Suite
Application ID
1319851
Contact Information
Contact Name
Mike Colt Shaw Kaminski Contractor
ROCK ROOFING INC
Phone Number
(425) 508-4362
Property Owner
Donald M & Peggy L Shaw LNI License#
ROCKRI*982RQ
Address
16123 N MEADOWDALE RD Phone#
(425) 508-4362
EDMONDS, WA City Bus. License#
Property Owner Phone
Tenant Name
Job Description
A (Single Family Residential) (Re -Roof Replacement - Roofing & Sheathing) 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: Mike Shaw
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1893
CITY OF EDMONDS
Building Permit
My6uildingPermitxom
Permit Information
Permit Number
RI n9n9*i_nR9n
Issued Date
5/22/2023
Expiration Date
11 /18/2023
Job Address
16123 MEADOWDALE RD
Fee Paid
$177.50
EDMONDS, 98026
Order Confirmation
1225582
Floor
Related Permit#
Suite
Application ID
1319851
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.
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