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Application_1319879CITY OF EDMONDS MyBuildingPermit.com Building Application #1319879 Applicant First Name Last Name Mike Shaw Company Name Number Street 16123 North Meadowdale Road Apartment or Suite Number E-mail Address mikeshaw.012@gmail.com City State Zip Edmonds WA 98026 Phone Number Extension (425) 681-7683 Contractor Company Name ROCK ROOFING INC Number Street 17210 Bothell Way N.E. Apartment or Suite Number City State Zip Bothell WA 98011 Phone Number Extension (425) 508-4362 State License Number License Expiration Date ROCKRI*982RQ 1 /6/2025 UBI # E-mail Address FD99_SfIBDD mikeshaw.012@gmail.com Project Location Number Street 16123 MEADOWDALE RD Floor Number Suite or Room Number City Zip Code EDMONDS 98026 County Parcel Number 00513300005003 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 Mike Shaw Number Street 16123 North Meadowdale Road Apartment or Suite Number City State Edmonds WA Zip 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: 5/22/2023 Submitted By: Mike Shaw Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1319879 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