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Application_2021-1484CITY OF EDMONDS MyBuildingPermit.com Building Application #1042062 Applicant First Name Last Name Company Name Tiana Cooper Four Seasons Roofing Number Street Apartment or Suite Number E-mail Address 17903 State Route 9 SE tiana@fourseasonsroof.com City State Zip Phone Number Extension SNOHOMISH WA 98296 (425)388-9906 Contractor Company Name FOUR SEASONS RFNG/RMDL SVS INC Number Street Apartment or Suite Number 16410 84th St NE #D513 City State Zip Phone Number Extension Lake Stevens WA 98258 425-388-9906 State License Number License Expiration Date UBI # E-mail Address FOURSRS016QA 4/11/2022 FB1 q799q.'1 tiana@fourseasonsroof.com Project Location Number Street Floor Number Suite or Room Number 1024 BROOKMERE DR City Zip Code County Parcel Number EDMONDS 98020 00397600001402 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 Alan C & Blickenstaff Lindsey Blickenstaff Number Street Apartment or Suite Number 1024 BROOKMERE DR City State Zip EDMONDS WA 98020 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: 10/28/2021 Submitted By: Tiana Cooper Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1042062 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