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Application_1182133CITY OF EDMONDS MyBuildingPermit.com Building Application #1182133 Applicant First Name Last Name Jacob Smith Company Name Valentine Roofing Inc. Number Street 400 Industry Drive Apartment or Suite Number E-mail Address #130 projectengineers@valentineroof.com City State Zip Tukwila WA 98188 Phone Number Extension (206) 575-7656 Contractor Company Name VALENTINE ROOFING INC Number Street 910 Industry Drive Apartment or Suite Number City State Zip Tukwila WA 98188 Phone Number Extension (206) 575-7807 State License Number License Expiration Date VALENR1927J8 4/28/2024 UBI # E-mail Address BD9R1g179 projectengineers@valentineroof.com Project Location Number Street 21110 SHELL VALLEY RD Floor Number Suite or Room Number City Zip Code EDMONDS 98026 County Parcel Number 00772100000200 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 Robert A & Jimenez Gladys A Freytag Number Street 16631 SE 15TH ST Apartment or Suite Number City State BELLEVUE WA Zip 98008 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: 8/2/2022 Submitted By: Jacob Smith Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1182133 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