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HomeMy WebLinkAbout912 5TH ST_BLD1261_2026 RE-ROOF J PERMIT APPLICATION Department of Community&Economic Development City of Arlington• 18204 59th Ave NE•Arlington, WA 98223• Phone(360)403-3551 Type of permit: (check one) (G)-kesidentialll ) ( ) Commercial Valuation: h y'Project Address:�` 2 �? ,�� T/ 112,7 Parcel ID#: Owner: �1M Address: City: State: Zip Code: Phone Number: f Email: 1 1 Applicant: .���11✓ TC� 1��,� � g .�� T 64v Address /� ,L�s �1-21 City: �YJVYJ�f State: Zip Code: S�O� Phone Number: rL�?T��1 �mail- Contractor: � Address: City: State: Zip Code. Phone Number: Email: Contractor's License Number: Expiration: Type of Roofing Material: 4_c-a 41a Number of Existing Layers: Class of Roofing: A a B ❑ C ❑ Replacing existing sheathing: Yes ❑ No Roof tear off: [B, Application over existing material: ❑ The following is required for NON-Residential Buildings: • Existing roof structure and material: • Two copies of the installation specifications and U.L. listed roof assembly. • Occupancy of Building: Office Retail Church Restaurant School I hereby certify the above information is correct and that the construction on, and the occupancy and the use of the above described property will be accordance with the laws, rules and regulations of the State of Washington. The applicant will be responsible for providing a method of safely accessing roof for inspection. A final inspection and approval shall be obtained when the re-roofing is complete. zzz Applicants Signature Date Print Applicants Name OR STAFF USE ONLY ' JSW 1 DEC 16 Z016 Permit# cepled&By �_Amount Received Receipt# Date Received 12/16/2016 BEST ROOFING&DECKING LLC Holm, ?apmol Contort Search L&I A-Z Indus 1101) \fy�f.&1 Safety&Health Claims&Insurance Workplace Rights Trades 8 Licensing 412*4 Washington State Department of " Labor & Industries BEST ROOFING & DECKING LLC Owner or tradesperson 5305158TH PL SW HURTADO MENDOZA,ALBERTO EDMONDS,WA 98026 425-248-8485 Principals SNOHOMISH County HURTADO MENDOZA,ALBERTO,MANAGER WA UBI No. Business type 604 029 414 Limited Liability Company License Verify the contractor's active registration/license/certification(depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. BESTRRD845N4 E ectrve— run 08/24/2016—08/24/2018 Bond Lexon Ins Co $12,000.00 Bond account no. 9818211 Received by L&I Effective date 08/24/2016 08/15/2016 Expiration date Until Canceled Insurance Preferred Contractors Ins Co R $1,000,000.00 Policy no. PC200023 Received by L&I Effective date 08/24/2016 08/15/2016 Expiration date 08/15/2017 Savings .......... ... No savi ngs accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period,but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. Help us improve https://secure.Ini.wa.gov/verify/Detail.aspx?UBI=604029414&LIC=BESTRRD845N4&SAW= 1/2 CITY OF ARLINGTON -ARLINGTON, WA. 98223 238 N. OLYMPIC AVE PHONE; (360) 403-3551 BUILDING PERMIT Address:912 E Fifth Street Permit#:1261 Parcel#:00411600300100 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:MELUM NICHOLI&SARAH Name:Alberto Hurtado Name:Best Roofing and Decking,LLC Address:UNKNOWN Address:5305 158th Place Address:5305 158th Place NE City,State Zip:UNKNOWN,WA City,State Zip:Edmonds,WA 98026 City,State Zip:Edmonds,WA 98026 Phone: Phone:425-248-8485 Phone:425-248-8485 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City,State,Zip: City,State,Zip: Phone: Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Residential Re-Roof CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: 1 OCC GROUP: BUILDINGS: OCC LOAD: PERMIT APPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY;NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBC110/IRC110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of Arlington must be reported on your sales tax return form and coded City of Arlington# 101. ignature Print Name Date Released By Datc. CONDITIONS Approved as submitted. THIS PERMIT AUTHORIZS ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION. PERMIT FEES Date Description Fee Amount 12/16/2016 Re-Roof $50.00 Total Due: $50.00 Total Payment: $50.00 Balance Due: $0.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon CITY OF ARLINGTON 238 N. OLYMPIC AVE-ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:912 E Fifth Street Permit#:1261 Parcel#:00411600300100 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:MELUM NICHOLI&SARAH Name:Alberto Hurtado Name:Best Roofing and Decking,LLC Address:UNKNOWN Address:5305 158th Place Address:5305 158th Place NE City,State Zip:UNKNOWN,WA City,State Zip:Edmonds,WA 98026 City,State Zip:Edmonds,WA 98026 Phone: Phone:425-248-8485 Phone:425-248-8485 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City,State,Zip: City,State,Zip: Phone: Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Residential Re-Roof CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: ] OCC GROUP: BUILDINGS: OCC LOAD: PERMIT APPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY;NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBC110/IRC110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of Arlington must be reported on your sales tax return form and coded City of Arlington# 101. 0 rk ignature Print Name Date Released By Dal CONDITIONS Approved as submitted. THIS PERMIT AUTHORIZS ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION. PERMIT FEES Date Description Fee Amount 12/16/2016 Re-Roof $50 00 Total Due: $50.00 Total Payment: $50.00 Balance Due: $0.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon J '' I .� I11! 1 ill - Permit Information Date 12/16/2016 Permit Number 1261 Project Name Melum Applicant Name Alberto Hurtado Applicant Address 5305 158th Place City,State,Zip Edmonds,WA 98026 Contact Alberto Hurtado Phone 425-248-8485 Email Permit Type Residential Re-Roof Site Address 912 E Fifth Street Valuation 0.00 Status Issued Permit Issued 12/16/2016 Permit Expires Square Feet 0 Type of Construction/Occupancy Load Number of Stories 0 Proposed Use Re-Roof with replacing sheathing Assigned To Kristin Foster Property Information Owner Information Parcelk 00411600300100 MELUM NICHOLI&SARAH MELUM NICHOLI&SARAH UNKNOWN 912 5TH ST UNKNOWN,WA Contractors Contractor Name Primary Contact Phone Email Contractor Type License L�nse (Best Roofing and Decking,LLC Alberto Hurtado 425-248-8485 CONSULTANT Fees Fee Description Notes Amount Re-Rool 322.1 0.00.Oq $50.0 Totaq $50.0 Payments Date Paid By Amount Description Payment Type Accepted B 12/16/2016 PNIberto Hurtado $50.00 2732756 [I;c Total $50.O1 Amount Outstanding:$0.Oa Uploaded Files Upload File Date File Uploaded B 12/16/2016 4:13758 PM 11261 Issued Permit.pd_f IFoster, Kristin 12/16/2016 4:13:57 PM 11261 Ap lication. df IFoster,Kristin RE-ROOF PERMIT APPLICATION 0 Department of Community& Economic Development City of Arlington • 18204 59th Ave NE•Arlington, WA 98223•Phone(360)403-3551 Type of permit: (check one) (G)kesidential ( )Commercial Valuation: l Project Address: 4 2 ' 6-2-)? S� r�17 �.�,�Parcel ID#: Owner: ► �v'1,� Address: City: State: Zip Code: Phone Number: / ?? (JJ Email: /may Applicant: /�/�J�✓ T� �;�j�y �� &���1 �t 1X.� 1 ��(✓ Address: �% ,��v�/-;!�2 PI ��City: !��?'1�L,� State: Zip Code: Phone Number: Contractor:_'�4 �� Address: City: State: Zip Code: Phone Number: Email: Contractor's License Number: Expiration: Type of Roofing Material: 4::a Zia Number of Existing Layers: Class of Roofing: A a B ❑ C ❑ Replacing existing sheathing: Yes ❑ No 0' Roof tear off. I Application over existing material: ❑ The following is required for NON-Residential Buildings: • Existing roof structure and material: • Two copies of the installation specifications and U.L. listed roof assembly. • Occupancy of Building: Office Retail Church Restaurant School I hereby certify the above information is correct and that the construction on, and the occupancy and the use of the above described property will be accordance with the laws, rules and regulations of the State of Washington. The applicant will be responsible for providing a method of safely accessing roof for inspection. A final inspection and approval shall be obtained when the re-roofing is complete. Z_/z z/e� Applicants Signature Date Print Applicants Name FOR STAFF USE ONLY muceivet q)'pI DEC 16 2016 Permit# Xcepted Amount Received Receipt# Date Received 1 211 61201 6 BEST ROOFING&DECKING LLC 1 pauol Cont�3`t Search L&I \-7,I ildcx i lelp \f I&I Safety&Health Claim,-& Insurance Workplace Rights Trades d Licensing Washington State Department of Labor & Industries BEST ROOFING & DECKING LLC Owner or tradesperson 5305 158TH PL SW HURTADO MENDOZA,ALBERTO EDMONDS,WA 98026 425-248-8485 Principals SNOHOMISH County HURTADO MENDOZA,ALBERTO,MANAGER WA UBI No. Business type 604 029 414 Limited Liability Company License Verify the contractor's active registration/license/certification(depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. BESTRRD845N4 Effec ive— x on:) 08/24/2016—08/24/2018 Bond Lexon Ins Co $12,000.00 Bond account no. 9818211 Received by L&I Effective date 08/24/2016 08/15/2016 Expiration date Until Canceled Insurance Preferred Contractors Ins Co R $1,000,000.00 Policy no. PC200023 Received by L&I Effective date 08/24/2016 08/15/2016 Expiration date 08/15/2017 Say.ings ................ .... No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period,but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. Flelp us improve h#ps://secure.ini.wa.gov/verify/Detail.aspx?UBI=604029414&LIC=BESTRRD845N4&SAW= 1/2 1 211 61201 6 BEST ROOFING&DECKING LLC Workers' comp No active workers'oomp accounts during the previous 6 year period. Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. ©Washington State Dept.of Labor&Industries.Use of Ihis site is subject to the laws of the state of Washington. l Help us improve https://secure.ini.wa.gov/verify/Detail.aspx?UBI=604029414&UC=BESTRRD845N4&SAW= M Permit#: 1261 Permit Date: 12/16/16 Permit Type: RESIDENTIAL RE-ROOF Project Name: Melum Applicant Name: Alberto Hurtado Applicant Address: 5305 158th Place Applicant, City, State, Zip: Edmonds, WA 98026 Contact: Alberto Hurtado Phone: 425-248-8485 Email: Scope of Work: Re-Roof with replacing sheathing Valuation: 0.00 Square Feet: 0 Number of Stories: 0 Construction Type: Occupancy Group: ID Code: Permit Issued: 12/16/2016 Permit Expires: Form Permit Type: Status: LASERFICHE Assigned To: Kristin Foster Property Parcel# Address Legal Description Owner Name Owner Phone Zoning 00411600300100 912 5TH ST MELUM NICHOLI 111 Single Family &SARAH Residence-Detached Contractors Contractor Primary Contact Phone Address Contractor Type License License Best Roofing and Decking, 5305 158th Place LLC Alberto Hurtado 425-248-8485 NE CONSULTANT Fees Fee Description Notes Amount Re-Roof Residential Residential $50.00 Total $50.00 Attached Letters Date Letter Description 12/16/2016 Building Permit Payments Date Paid By Description Payment Type Accepted By Amount 12/16/2016 Alberto Hurtado 62732756 cc $50.00 Outstanding Balance $0.00 Uploaded Files Date File Name 12/16/2016 2014798-1261 Issued Permit.pdf 12/16/2016 2014797-1261 Application.pdf