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Application_1400165CITY OF EDMONDS MyBuildingPermit.com Building Application #1400165 Applicant First Name Last Name Company Name Aza Cline Mountain GoatRoofing Number Street Apartment or Suite Number E-mail Address 0278 mgroofs@yahoo.com City State Zip Phone Number Extension Lynnwood WA 98046-0278 (206) 841-1645 Contractor Company Name Mountain Goat Roofing Number Street Apartment or Suite Number 0278 City State Zip Phone Number Extension Lynnwood WA 98046-0278 (206) 625-0190 State License Number License Expiration Date UBI # E-mail Address MOUNTGR025D7 6/25/2024 FD1774RR7 mgroofs@yahoo.com Project Location Number Street Floor Number Suite or Room Number 10712 228TH ST SW City Zip Code County Parcel Number EDMONDS 98020 00637800000600 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 Todd J Ames & Patricia M Ellermeier Number Street Apartment or Suite Number 10712 228TH PL SW 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: 11/4/2023 Submitted By: Aza Cline Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Building Application #1400165 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