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HomeMy WebLinkAbout17504 40th Dr Ne_BLD2853_2026 CITY OF ARLINGTON Go 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 Address:17504 40th Dr NE BUILDING PERMIT Parcel#:00934700003100 Permit#:2853 Valuation: 11950,00 OWNER APPLICANT CONTRACTOR Name:KORTH BRIAN S&LOLITA C Name:S&S Roofing LLC Address:17504 40TH DR NE Name:S&S Roofing,LLC Address:104 S West Ave Address:104 S West Ave City,State Zip:ARLINGTON,WA 98223-3707 City,State Zip:Arlington Phone: City,State Zip:Arlington,WA 98223 Phone:3603869903 Phone:3603869903 LIC:SSROOSR918MM EXP:08/03/2021 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Address: Name: City,State,Zip: Address: Phone: City,State,Zip: LIC,#: Phone: JOB DESCRIPTION EXP: LIC#: EXP: PERMIT TYPE: Residential Re-Roof CODE YEAR: 2015 STORIES: DWELLING UNITS: CONST.TYPE: BUILDINGS: OCC GROUP: 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 WASHING HE 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. IBC1]0/LRC110. 794 ANOTICE: to c ruction an nsttuction materials in the City of Arlington must be reported on your sates tax retuni form 10/17/19 P Date Rolea• By Date CONDITIONS Call for final inspection. THIS PERMIT AUTHORIZES ONLY THE WORK NOTED.THIS PER CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS, IT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY DRIVEWAYS,MARQUEES.ETC.)WILL REQUIRE SEPARATE PERMISSION. Date Description PERMIT FEES 10/16/2019 Processing/Technology Fee Fee Amount $25.00 Total Due: $25.00 Total Payment: $0.00 CALL FOR INSPECTIONS Balance Due: $25.00 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 i ,� i Permit#: 2853 Permit Date: 10/16/19 Project Name: Korth Site Address: 17504 40th Dr NE Company Name: S&S Roofing LLC Company Address: 104 S West Ave City, State,Zip: Arlington Contact: Dana Johnson Phone: 3603869903 Email: danasandsroofing@hotmail.com Permit Type: Residential Re-Roof Valuation: 11950.00 Square Feet: 0 Number of Stories: 0 Type of Construction: Occupancy Type: Proposed Use: Re-Roof Non structural MIC/Opportunity Zone: Permit Issued: Permit Expires: Type of Construction-DNU: Status-DNU: Status: IN PROCESS Property Parcel# Address Legal Description Owner Name Owner Phone Zoning KORTH BRIAN S& 111 Single Family 00934700003100 17504 40TH DR NE LOLITA C Residence- Detached Contractors Contractor Primary Contact Phone Address Contractor Type License License# S&S Roofing,LLC Shane Dunlap 3603869903 104 S West Ave CONTRACTOR Labor& SSROOSR918MM Industries Fees Fee Description Notes Amount Processing/Technology Fee 341.43.00.02 $25.00 Total $25.00 Uploaded Files Date File Name 10/16/2019 5757 4t5_'8i; \phlication.pdf RE-ROOF f PERMIT APPLICATION �L► Department of Community& Economic Development City of Arlington • 18204 59th Ave NE • Adington, WA 98223 • Phone (360) 403-3551 Type of permit: check one Residential 11,950.00 yp p ( ) (�/) ) Commercial valuation:_ 17504 40th Dr. NE Arlington, WA 98223 Project Address: - Parcel ID#: - Owner: Brian Korth Address: 17504 40th Dr. NE City:Arlington State: WA Zip Code:98223 Phone Number: 206-427-5321 Email:jennifersandsroofing@hotmail.com Applicant:S & S Roofing LLC Address: 104 S West Ave City.Arlington State: WA Zip Code:98223 360-386-9903 jennifersandsroofing@hotmail.com Phone Number: Email S & S Roofing LLC Contractor: 104 S. West Ave Arlington WA 98223 Address: City: State: Zip Code: 360-386-9903 jennifersandsroofing@hotmail.com Phone Number: Email: SSROOSR918MM 8/3/21 Contractor's License Number: Expiration: Owens Corning True Definition 1 Type of Roofing Material. Number of Existing Layers: Class of Roofing: A ✓❑ B ❑ c ❑ Replacing existing sheathing: Yes ❑ No ✓❑ Roof tear off: © 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. (� Lea. /�r�Jooc_ 10/15/2019 Applicants Signature Date Dana Johnson Print Applicants Name FOR STAFF USE ONLY eceive ,VV 00 OCT 16 2019 Permit# A t nc:i By Amount Received Receipt# Date Received ►_ w 1 1 .� I r Home Espahol Contact Search L&I i Safety&Health 0 Claims&Insurance C2 Workplace Rights 6 Trades&Licensing Washington State Department of " labor & Industries S &S ROOFING LLC Owner or tradesperson 104 S WEST AVE Principals ARLINGTON,WA 98223 JOHNSON,NANCY,PARTNER/MEMBER 360-386-9903 SNOHOMISH County ■ DUNLAP,SHERI LYNN,PARTNER/MEMBER ■ DUNLAP,SHERI LYNN,AGENT ■ DUNLAP,SHANE STEVEN,PARTNER/MEMBER (End:08/03/2011) ■ JOHNSON,STEVEN MICHAEL,PARTNER/MEMBER (End:08/03/2011) Doing business as S&S ROOFING LLC WA UBI No. Business type 602 934 849 Limited Liability Company Governing persons SHERI DUNLAP NANCYJOHNSON; SHANE DUNLAP; STEVEN M JOHNSON; License Verify the contractor's active registration/license/certification(depending on trade)and any past violations. Construction Contractor Active Meets current requirements. License specialties ROOFING License no. SSROOSR918MM Effective—expiration 07/15/2009—08/03/2021 Bond CBIC $6,000.00 Bond account no. SI3456 Received by L&I Effective date 07/14/2009 07/15/2009 r Expiration date 11 Until Canceled Insurance j Houston Specialty Ins Co $1,000,000.00 Help us improve Policy no. TEN23542 Received by L&I Effective date 07/11/2019 07/15/2019 Expiration date 0 711 5/2 0 2 0 Insurance history Savings .................. ... 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&1 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. Certifications & Endorsements I i OMWBE Certifications No active certifications exist for this business. Apprentice Training Agent 11.111, 1,11111. Not allowed to have apprentices. Workers' comp Do you know if the business has employees?If so,verify the business is up-to-date on workers'comp premiums. L&I Account ID Account is current. 178,628-00 Doing business as S&S ROOFING LLC Estimated workers reported Quarter 2 of Year 2019"31 to 50 Workers" L&I account contact T3/STEPHANIE HENDERSON(360)902-5598-Email:HSTE235@lni.wa.gov Public Works Requirements Verify the contractor is eligible to perform work on public works projects. Required Training—Effective July 1,2019 Exempt from this requirement. Contractor Strikes No strikes have been issued against this contractor. Contractors not allowed to bid No debarments have been issued against this contractor. Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. Inspection results date 05/08/2019 Violations Inspection no. 317954022 Location ' 2629 NE 82nd St Seattle,WA 98115 Inspection results date 07/09/2018 Violations Inspection no. Help us improve 317949404 ,i Location 1106 Ekle St Camano Island,WA 98282 ` w WaShinktuI i ��, RE-ROOF 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) (v) Residential ( ) Commercial Valuation: 11,950.00 17504 40th Dr. NE Arlington, WA 98223 Project Address: Parcel ID#: Owner: Brian Korth Address: 17504 40th Dr. NE City:Arlington State: WA Zip Code:98223 Phone Number: 206-427-5321 Email:jennifersandsroofing@hotmail.com Applicant: S & S Roofing LLC Address: 104 S West Ave City:Arlington State: WA Zip Code:98223 360-386-9903 jennifersandsroofing@hotmail.com Phone Number: Email: S & S Roofing LLC Contractor: 104 S. West Ave Arlington WA 98223 Address: City: State: Zip Code: 360-386-9903 jennifersandsroofing@hotmail.com Phone Number: Email: S S ROOS R918 M M 8/3/21 Contractor's License Number: Expiration: Type of Roofing Material: Owens Corning True Definition Number of Existing Layers: 1 Class of Roofing: A ✓❑ B ❑ C ❑ Replacing existing sheathing: Yes ❑ No ✓❑ Roof tear off: © 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 Retai I 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. es,9�,d�,� e�me=,o�=�om a�c25L�rcaa� 10/15/2019 Applicants Signature Date Dana Johnson Print Applicants Name FOR STAFF USE ONLY Permit# Accepted By Amount Received Receipt# Date Received CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360) 403-3551 BUILDING PERMIT i Address:17504 40th Dr NE Permit#:2853 Parcel#:00934700003100 Valuation: 11950.00 OWNER APPLICANT CONTRACTOR Name:KORTH BRIAN S&LOLITA C Name:S&S Roofing LLC Name:S&S Roofing,LLC Address: 17504 40TH DR NE Address:104 S West Ave Address: 104 S West Ave City,State Zip:ARLINGTON,WA 98223-3707 City,State Zip:Arlington City,State Zip:Arlington,WA 98223 Phone: Phone:3603869903 Phone:3603869903 LIC:SSROOSR918MM EXP:08/03/2021 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City,State,Zip: City,State,Zip: Phone: Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION W 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. IBCl l0/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#3101. 10/17/19 Signature Print Name Date Relea By Date CONDITIONS Call for final inspection. THIS PERMIT AUTHORIZES 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 10/16/2019 Processing/Technology Fee $25.00 Total Due: $25.00 Total Payment: $0.00 Balance Due: $25.00 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 Permit#: 2853 Permit Date: 10/16/19 Permit Type: RESIDENTIAL RE-ROOF Project Name: Korth Applicant Name: S&S Roofing LLC Applicant Address: 104 S West Ave Applicant, City, State, Zip: Arlington Contact: Dana Johnson Phone: 3603869903 Email: danasandsroofing@hotmail.com Scope of Work: Re-Roof Non structural Valuation: 11950.00 Square Feet: 0 Number of Stories: 0 Construction Type: Occupancy Group: ID Code: Permit Issued: 10/17/2019 Permit Expires: Form Permit Type: Status: COMPLETE Assigned To: Raelynn Jones Property Parcel# Address Legal Description Owner Name Owner Phone Zoning 00934700003100 17504 40TH DR NE KORTH BRIAN S& 111 Single Family LOLITA C Residence-Detached Contractors Contractor Primary Contact Phone Address Contractor Type License License# 104 S WEST CONSTRUCTION COA Business S&S ROOFING LLC 3603869903 602 934 849 AVE CONTRACTOR License 104 S WEST CONSTRUCTION Labor& SSROOSR918MM S&S ROOFING LLC 3603869903 AVE CONTRACTOR Industries Fees Fee Description Notes Amount Processing/Technology $25.00 Total $25.00 Attached Letters Date Letter Description 10/16/2019 Building Permit Payments Date Paid By Description Payment Type Accepted By Amount 10/17/2019 Dana Johnson 77552074 $25.00 Outstanding Balance $0.00 Uploaded Files Date File Name 10/16/2019 5757595-2853 Application.pdf CITY of ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON,WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:17504 40th Dr NE Parcel#:00934700003100 Permit#:2853 Valuation: 11950.00 OWNER APPLICANT CONTRACTOR Name:KORTH BRIAN S&LOLITA C Name:S&S Roofing LLC Name:S&S Roofing,LLC Address: 17504 40TH DR NE Address:104 S West Ave City,State Zip:ARLINGTON,WA 98223-3707 City,State Zip:Arlington Address:104 S West Ave Phone: City,State Zip:Arlington,WA 98223 Phone:3603869903 Phone:3603869903 MECHANICAL CONTRACTOR LIC:SSROOSR918MM EXP:08/03/2021 PLUMBING CONTRACTOR Name: Address: Name: Address: City,State,Zip:Phone: City,State,Zip: Phone: LTC#: EXP: LIC#: JOB DESCRIPTION EXP. 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 A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBC 110/IRC 110. OR SALES TAX NOTI .E:Sa s tax relating to c ction an nstruction materials in the City of Arlington must be reported on your sales tax return form d City of Tw- 1 t ahir �ZQ2 10/17/19 P Date Relea B Y Datc CONDITIONS Call for final inspection. THIS PERMIT AUTHORIZES 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 10/16/2019 Processing/Technology Fee Fee Amount $25.00 Total Due: S25.00 Total Payment: $0.00 Balance Due: $25.00 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