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Permit_BLD2023-0709CITY OF EDMONDS Building Permit My6uildingPermitxom Permit Information Permit Number RI f17f17'i_n7nQ Issued Date 6/7/2023 Expiration Date 12/4/2023 Job Address 19208 76TH AVE W Fee Paid $177.50 EDMONDS, 98026 Order Confirmation 1229884 Floor Related Permit# Suite Application ID 1329551 Contact Information Contact Name Mike Bieniek Contractor Krown Homes LLC Phone Number (206)391-6767 LNI License# KROWNHL817B9 Property Owner David R Truax Address 19208 76TH AVE W EDMONDS, WA Phone# (206)391-6767 City Bus. License # 6043866080 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: Mike Bieniek Page 1 of 2 t °F EDAf 0 1893 CITY OF EDMONDS Building Permit My6uildingPermitxom Permit Information Permit Number RI n9n9*i_(17nQ Issued Date 6/7/2023 Expiration Date 12/4/2023 Job Address 19208 76TH AVE W Fee Paid $177.50 EDMONDS, 98026 Order Confirmation 1229884 Floor Related Permit# Suite Application ID 1329551 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