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Application_BLD2023-0814CITY OF EDMONDS MyBuildingPermit.com Building Application #1340903 Applicant First Name Last Name Company Name Kristy Hoff Cornerstone Roofing, Inc. Number Street Apartment or Suite Number E-mail Address 8805 206th Street SE Kristy@cornerstoneroofing.com City State Zip Phone Number Extension Snohomish WA 98296 (425) 485-0111 Contractor Company Name CORNERSTONE ROOFING INC Number Street Apartment or Suite Number 8805 206TH ST SE City State Zip Phone Number Extension Snohomish WA 98296 (206) 786-5241 State License Number License Expiration Date UBI # E-mail Address CORNER1011CM 3/8/2024 FD1 RR95D9 kristy@cornerstoneroofing.com Project Location Number Street Floor Number Suite or Room Number 21103 84TH AVE W City Zip Code County Parcel Number EDMONDS 98026 00373600100711 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 EDMONDS 21103 LLC Number Street Apartment or Suite Number 615 NW 162ND ST City State Zip SHORELINE WA 98177 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: 6/29/2023 Submitted By: Kristy Hoff Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1340903 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