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HomeMy WebLinkAbout4722 197TH PL NE_BLD1323_2026 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) Residential ( ) Commercial Valuation: l�'��• — Project Address: - -7 Ja N—I t' 1 I Lf- Parcel ID#: Owner: YAM Address: l JJS City:�,_e6p State: �� • Zip Code: Phone Number: Email: Applicant: Address: City: State: Zip Code: Phone Number: ,�t^^ Email: Contractor: 0 — Address: — City: State: Zip Code: Phone Number: c� c/ Email: Contractor's License Number: -- 1 J t r r ` Expiration: r J ap Type of Roofing Material: T�i e, �� �z Number of Existing Layers: 1 Class of Roofing: A ❑ B ❑ C ❑ Replacing existing sheathing: Yes No ❑ Roof tear off: 01 Application over existing material: ❑ The following is required for NON-Residential Buildings: • Existing roof structure and material: ��2✓— ���� • 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. 0 � 0, App i ignature Date r 1,A4E Print Applicants Name FOR STAFF USE ONLY Permit# Accepted By Amount Received Receipt# Date Received CITY OF ARLINGTON M 1 l 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:4722 197th Place NE Permit#: 1323 Parcel#:00671900001800 Valuation: 12000.00 OWNER APPLICANT CONTRACTOR Name:SANCHEZ LIBRADO&TAUNYA M Name:Eugene Graeme Name:WCI Construction,LLC Address:4722 197TH PL NE Address:169 SE Cody Lane Address: 169 SE Cody Lane City,State Zip:ARLINGTON,WA 98223-8734 City,State Zip:Madras,OR City,State Zip:Madras,OR 97741 Phone: Phone:541-279-0767 Phone:541-279-0767 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: 1 CONST.TYPE: DWELLING UNITS: 1 OCC GROUP: BUILDINGS: OCC LOAD: r� 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 ofAr11,V*> trust be rted on your sales tax return form and coded City of Arlington#3101. Signature Print Name Date Released By Date CONDITIONS Approved as submitted. Sheathing inspection is required. 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 2/10/2017 Processing/Technology Fee $25.00 2/10/2017 Re-Roof $50 00 Total Due: $75.00 Total Payment: $0.00 Balance Due: $75.00 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 $10.. $34 $5' 1 CITY OF ARLINGTON 238 N.OLYMPIC AVE-ARLINGTON,WA.98223 PHONE;(360)403-3551 BUILDING PERMIT Address:4722 197tY Place NE Permit#:1323 Parcel#:00671900001800 Valuation:12000.00 OWNER APPLICANT CONTRACTOR y Name:SANCHEZ LIBRADO&TAUNYA M Name:Eugene Graeme Name:WCI Construction,LLC Address:4722 197TH PL NE Address:169 SE Cody Lane Address:169 SE Cody Lane City,State Zip:ARLINGTON,WA 98223-8734 City,State Zip:Madras,OR City,State Zip:Madras,OR 97741 Phone: Phone:541-279-0767 Phone:541-279-0767 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 1 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 TIi£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 TIIE 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. 113C 1 l0/IRC 110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of Arlingtunptust be r-ported on your sales tax return form and coded O Arlington#3101, Signature Print Name Date Released By Date CONDITIONS Approved as submitted. Sheathing inspection is required. THIS PERMIT AIJTIIORIZS ONLY TIIE WORK NO'PE:D "PHIS PERMI'I'COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON't1LE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,E't'C)WILL REQUIRE;SEPARATE PERMISSION. PERMIT FEES Date Description Fee Amount 2/10/2017 Processing/Technology Fee $25.00 2/10/2017 Re-Roof $50.00 Total Due: $75.00 Total Payment: $0.00 Balance Due: $75.00 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 $to, $34 CI `Y OF ARLINGTON $5� 23$ N �. OLYMPIC AVEA VE-ARLINGTON,WA,98223 PHONE;(360)403-3551 BUILDING PERMIT Address:4722 197th Place NE Parcel k:00671900001900 PermitM. 3323 OWNER Valuation:12000.00 m Nae:SANCHEZ LIBRADO&TAUNYA M pLICANT CONTRACTOR Address;4722 I97T '°`dd H PL NE EuBcnc Graemc S �ss:169 SE Cody Lane NUM:WCI Construction,LLC City,State Zip:ARLINGTON,WA 98223-8734 City, Stale Zip:Madras,OR Address:169 SE Cody Lane Phone: Phoate- 541-279-0767 City,State Zip:Madras,OR 97741 MECHANICAL CONTRACTOR Phone:541-279-0767 Name: PLUMBING CONTRACTOR Address: Name: City,State,Zip: Address: Phone: City,State,Zip: LIC N: EXP., Phone: JOB DESCRIPTION LIC p: EXP: PERMIT TYPE: Residential Re-Roof CODE YEAR: 2015 STORIES: 1 DWELLING UNITS: CONST.TYPE: l BUILDINGS: OCC GROUP: OCC LOAD: PERMIT APPROVAL I AGRIiF.TO COMPLY W ITII CITY AND STA'iTHERE [i L.A W ti REt1Ul A'11NG CONS'1'RUCfIUN ANO IN WORKMEN'S 'S OMEPERSON WILL BE SURA C 1 N VlOI.A1'ION OF TIIE LABOR CODE OF TI IE S'fA'fli OF WASHINGTON R1 LATTNG TO WORKMEN:S COMPENSATION INSl1RANC1i ANp DOING THE WORK Al1THUR1l.ED RC:W IR.27. fN1S APPLICATION IS NOT A PERMIT UNTI L SKHVEU OY'fl IE 9I11LDING OFFICIAL OR HISIHiER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A HIMI.1)IN(;OR STRUCruRE UNTit.A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS IiIiIEN 4RANTL•0. IHCI 10/IRCI 10, SALES TAX NOTW •Sales tax relating to construction andeonsuuction and coded t< Arhnglon 83101, materials in the City ofAriingtuninust be 411 elf ported on your sales tax return form Signature Date Released By / CONDITIONS Date Approved as submitted. Sheathing inspection is required. THIS PERMIT A N T11E PU ONLY'n IE I NOTI-1)ilits PERMIT COVERS WO7� i 13E DONE ON CONSTRUCTION ON'nIE PUBLIC DOMAIN("RBS,810I;WAI.K 1.URIVGWgyS h1ARQl1EE5,ETC)WILL REQl1IRP SEPARATE P1.RMWSY PRIVATE PROPERTY ONLY, ANY Date Description PERMIT FEES 2/10/2017 Processingrrechnolog�Fe, 2/10/2017 Re-Roof Fee Amount $25.00 Total Due: $50 00 s75.00 Total Payment: $0.00 CALL FOR INSPECTIONS Balance Due: $75.00 RIJ11.I)IN(%(360)403-341. When calling for an Inspection please IeAve the ILI"wiog Information: Permit Number,Type or Inspection being requested,and Nr hcrhrr you prefer morning or afternoon ,.ow CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360) 403-3551 BUILDING PERMIT Address:4722 197th Place NE Permit#:1323 Parcel#:00671900001800 Valuation: 12000.00 OWNER APPLICANT CONTRACTOR Name:SANCHEZ LIBRADO&TAUNYA M Name:Eugene Graeme Name:WCI Construction,LLC Address:4722 197TH PL NE Address:169 SE Cody Lane Address: 169 SE Cody Lane City,State Zip:ARLINGTON,WA 98223-8734 City,State Zip:Madras,OR City,State Zip:Madras,OR 97741 Phone: Phone:541-279-0767 Phone:541-279-0767 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: I 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 ofAritpgto ust be rted on your sales tax return form and coded City of Arlington#3101. 2—16 17 Signature Print Name Date Released By Date CONDITIONS Approved as submitted. Sheathing inspection is required. 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 2/10/2017 Processing/Technology Fee $25.00 2/10/2017 Re-Roof $50.00 Total Due: $75.00 Total Payment: $0.00 Balance Due: $75.00 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 Information Date 2/8/2017 Permit Number 1323 Project Name Carrington Mortgage Applicant Name Eugene Graeme Applicant Address 169 SE Cody Lane City,State,Zip Madras,OR Contact Eugene Graeme Phone 541-279-0767 Email genegraeme@aol.com Permit Type Residential Re-Roof Site Address 4722 197th Place NE Valuation 12000.00 Status Applied Permit Issued Permit Expires Square Feet 0 Type of Construction/Occupancy Load Number of Stories 0 Proposed Use Residential re-roof with replacing sheathing Assigned To Kristin Foster Property Information Owner Information Parcel#:00671900001800 SANCHEZ LIBRADO&TAUNYA M SANCHEZ LIBRADO&TAUNYA M 4722 197TH PL NE 4722 197TH PL NE ARLINGTON,WA 98223-8734 Contractors Contractor Name Primary Contact Phone Email Contractor Type7_andl�,dstne, se License# CI Construction, LLC Eu ene Graeme 541-279-0767 enegraeme@aol.com CONTRACTOR Lau 011I11CL839CS Review Date Type Description Target Date Completed Date Assigned To Status /10/2017 Re Roof Kevin Olander In Review /10/2017 Re-Roof Rick Karns In Review Fees Fee Description Notes Amount Processinqrrechnology Fee 341,43.00-02 $25.00 Re-Roof 322.10.00.0a I $50.01 Total $75 0 Uploaded Files Upload File Date File Uploaded B 2/8/2017 1:42:43 PM 11323 n plication. df Foster,Kristin RE-ROOF PERMIT APPLICATION Department of Community&Economic Development City of Arlington• 18204 59th Ave NE•Arlington, WA 98223•Phone(360)403-3551 Type of permit: (check one) Residential ( )Commercial Valuation: ( - Project Address: �� N ��, t' i Parcel ID#: Owner: — Cr4r r. O"^ h"'IlDf (� / fAf Address: �7 p�t.S�A s s City: -�=M State: C"t - Zip Code: 9 236 n Phone Number: Email: Applicant: Address: City: State: Zip Code: Phone Number: L Email: Contractor: W!.T Cc,"`S-yk',f�Dh I I C Address: Sf' G-du k"p City: Dn1rKJ"2-5 State: CC-- Zip Code: Phone Number: I (� r Email: -e F-A P w-,�0,� �- y�`f ��' .n Con Expiration: r� 1 Contractor's License Number:—� -!1 Type of Roofing Material: i e< Number of Existing Layers: / Class of Roofing: A ❑ B ❑ C ❑ Replacing existing sheathing: Yes ,� No ❑ Roof tear off: 0 Application over existing material: ❑ The following is required for NON-Residential Buildings: 1 L • Existing roof structure and material: � r J h A k,-- • Two copies of the installation specifications and U.L.listed roof assembly. • Occupancy of Building: Office Retail Church Restaurant _— School I hereby certify the above information is correct and that the construction on, and the occupancy and the use of the above described property will be accordance with the laws, rules and regulations of the State of Washington. The applicant will be responlsible for providing a method of safely accessing roof for inspection. A final inspection and approval shall be obtained when the re-roofing is complete. a -3-r-7 App t ignalure Date CLA,qP,nQ a w"$ Print Applicants Name FOR STAFF USE ONLY Fei 75E �23 _ FEB 0 ?.017 Liermit# Amount Received Receipt# Date Reoelved 2/10/2017 WCI CONSTRUCTION LLC 1 Iran ;<,3, Search L&I Vllyd . Ilrl�, .Iv 1&i ,Safely&id.ealth Claims&Insurance VI/nrkplaca Richis F-adesAlIk ricer?ssr� Washington State Department of " Labor & Industries WCI CONSTRUCTION LLC Owner or tradesperson 169 SE CODY LANE GRAEME,EUGENE BURNS MADRAS, OR 97741 541-279-0767 Principals GRAEME, EUGENE BURNS, PARTNER/MEMBER WA UBI No. Business type 604 046 143 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. WCICOCL839CS Effective—expiration 02/10/2017—02/10/2019 Bond Wesco Insurance Co $12,000.00 Bond account no. 46WBO83386 Received by L&I Effective date 02/10/2017 02/09/2017 Expiration date Until Canceled Insurance Arch Insurance Co $1,000,000.00 Policy no. AGL001551002 Received by L&I Effective date 02/10/2017 07/15/2016 Expiration date 07/15/2017 S.avings ............... .... 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. hitps://secure.Ini.wa.gov/verify/Detail.aspx?UBI=604046143&LIC=W CICOCL839CS&SAW= 1/2 2/10/2017 WCI CONSTRUCTION LLC Workers' comp No active workers'comp 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 this site is subject to the laws of the state of Washington. Help us improve https://secure.Ini.wa.gov/verify/Detail.aspx?U BI=604046143&LIC=W CICOC L839CS&SAW= 2/2 Date: 04/06/2026 Permit#: 1323 Perm Date: 02/08/2017 Review Date: 02/10/2017 Perm Type: RESIDENTIAL RE-ROOF Review Type: RESIDENTIAL RE-ROOF Target Date: Scheduled Time 00:00 Com pleted Date: 02/10/2017 Description: sheathing nailing inspection required. Review Status: Assigned To: z.Rick Karns Tim eIn: 00:00 Time O it: 00:00 H curs: 0.0 Property Information Parcel#: 00671900001800 S ANCHEZ LIBRADO & TAUNYA M SANCHEZ LIBRADO &TAUNYA M 4 722 197TH PL NE 4722 197TH PL NE A RLINGTON, WA98223-8734 Zoning: 111 Single Fam iy Residence - DetachedLot: Block: Permit#: 1323 Permit Date: 02/08/17 Permit Type: RESIDENTIAL RE-ROOF Project Nam e Carrington Mortgage Applicant Nam a Eugene Graem e Applicant Address: 169 SE Cody Lane Applicant, City, State, Zip: Madras, OR Contact: Eugene Graem e Phone: 541-279-0767 Email: genegraem u@aol.com Scope of Work: Residential re-roof with replacing sheathing Valuation: 12000.00 Square Feet: 0 Num ber of Stories: 0 Construction Type: O xupancy G ioup: ID Code: Permit Issued: 02/10/2017 Permit Expires: Form Permit Type: Status: LASERFICHE Assigned To: Kristin Foster Property Parcel# Address L egal Description O wner Nam e Caner Phone Zoning SANCHEZ 00671900001800 4 722 197TH PL NE LIBRADO& Residence Single Dam iy -Detached TAUNYA M Contractors Contractor P rim ay Contact P hone A ddress C ontractor Type L icense License# WCI Construction,LLC E ugene Graem e1-279-0767 169 SE Cody CONSTRUCTION Labor andWCICOCL839CS Lane CONTRACTOR Industries Plan Reviews Date R eview Type D escription A ssigned To R eview Status 02/10/2017 R ESIDENTIAL RE-ROOF B UILDING 02/10/2017 R ESIDENTIAL RE-ROOF s heathing nailing inspection required. z .Rick Karns Fees Fee D escription N otes A in cunt Processing/Technology $25.00 Re-Roof Residential R esidential $50.00 Total $75.00 Attached Letters Date Letter D escription 02/10/2017 Building Perm i Paym sits Date Paid By D escription P aym ant Type A ccepted By A m mnt 02/10/2017 Eugene Graem e 6464502 c c $75.00 O ttstanding Balance $0.00 Uploaded Files Date File Nam e 02/13/2017 2100260-1327 Issued Perm i.pdf 02/08/2017 2092624-1323 Application.pdf