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HomeMy WebLinkAbout17803 83RD DR NE_BLD2323_2026 CITY OF ARLINGTON 238 M OLYMPIC AVE-ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address: 17803 83rd Dr NE Permit#:2323 Parcel#:00958500005100 Valuation:7620.00 OWNER APPLICANT CONTRACTOR Nome:GREENSHAW LISA D Name:S&S Roofing LLC Name:S&S Roofing,I.LC Address: 17803 83RD DR NE Address:104 S.West Ave Address:P.O.Box 969 City,State Zip:ARLINGTON,WA 982234039 City,State Zip:Arlington,WA 98223 City,State Zip:Marysvilte,WA 98270 Phone: Phone:360-386-9903 Phone:360-386-9903 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 CUNSTRU(..-nON AND IN DOING THE.WORK AUTHORIZED TIIEREBY: NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASIIINGTON 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. I13C11011RC 110. 1' t 1!A O I*1 "-Sa tax relating to construction and constriction materials in the City of Arlington must be reported on�jrsalesax return form aI coded City of Arli ttn IQJ.� — — I K I ignalure Print Name Date Rclr,tisc B Date CONDITIONS (. Please call for final inspection. THIS PERMIT AUTIIORIZS 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 Data Description Fee Amount 12/26/2018 Processing/Technology Fee $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 iavptedon please leave the following information: Permit Number,Type of Inspection being requested,and whether voii prefer morning or afternoon r-� Permit Information Date 12/26/2018 Permit Number 2323 Project Name S&S Re Roof 17803 83rd Dr Applicant Name S&S Roofing LLC Applicant Address 104 S.West Ave City,State,Zip Arlington,WA 98223 Contact Phone 360-386-9903 Email jennifersandsroofing@hotmail.com Permit Type Residential Re-Roof Site Address 17803 83rd Dr NE Valuation 7620.00 Status Applied Permit Issued Permit Expires Square Feet 0 Type of Construction/Occupancy Load Residential Re-Roof Number of Stories 0 Proposed Use Re-Roof Non structural Assigned To Raelynn Jones Property Parcel Address Le al Owner Owner Phone Zoning 00958500005100 117803 83RD DR NE I IGREENSHAW LISA D 111 Single Family Residence-Detached Contractors Contractor Name Primary Contact Phone Email Contractor Type License License# S&S Roofing,LLC Shane Dunla 360-386-9903 5hanesandsroofina(a)hotmail.com :ONTRACTOR ILabor&Industries 3SROOSR918MM Fees Fee Description Notes Amount Processing/Technology Feel 341.43.00.021 $25.00 Totall $25.00 Uploaded Files Upload File Date File Uploaded B 12/26/2018 8:45:54 AM 12323 Application.pdf I Jones, Raelynn { I I CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address: 17803 83rd Dr NE Permit#:2323 Parcel#:00958500005100 Valuation:7620.00 OWNER APPLICANT CONTRACTOR Name:GREENSHAW LISA D Name:S&S Roofing LLC Name:S&S Roofing,LLC Address: 17803 83RD DR NE Address:104 S.West Ave Address:P.O.Box 969 City,State Zip:ARLINGTON,WA 98223-4039 City,State Zip:Arlington,WA 98223 City,State Zip:Marysville,WA 98270 Phone: Phone:360-386-9903 Phone:360-386-9903 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City,State,Zip: City,State,Zip: Phone: Phone: LTC#: 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. IBC 110/IRC 110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of Arlington must be reported on y ur sales tax return form and coded City of Arlington 93101. 1/ Signature Print Name Date ReIG seU Date / CONDITIONS (C Please call for final inspection. 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 12/26/2018 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 <_ 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 7620.00 yp p ( ) (� ( ) Commercial Valuation: 17803 83rd Dr. NE Arlington, WA Project Address: Parcel ID#: Owner: Eddie Ness Address: 17803 83rd Dr. NE City:Arlington State: WA Zip Code:98223 Phone Number: 425-346-8988 Email:Jennifersandsroofing@hotmail.com Applicant: S & S Roofing LLC Address: 104 S. West Ave City:Arlington State: WA Zip Code:98223 425-346-8988 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 R918M M 8/3/2019 Contractor's License Number: Expiration: Pabco Type of Roofing Material: 260 pound per sq. 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 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. ir 12/24/2018 Applicants Signature Date Dana Johnson Print Applicants Name �f f�� FOR STAFF USE ONLY Permit# Accep By Amount Received Receipt# Date Received Horne Espahol Contact Search L&ISEARcH Labori Industries Workplace Ri• .• • Washington State Department of " Labor & Industries S & S ROOFING LLC Owner or tradesperson 104 S West Ave. ARLINGTON,WA 98223 Principals 360-386-9903 JOHNSON,NANCY,PARTNER/MEMBER 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—08/03/2019 Bond CBIC $6,000.00 Bond account no. S13456 Received by L&I Effective date 07/14/2009 07/15/2009 Expiration date Until Canceled Insurance Houston Specialty Ins Co $1,000,000.00 Policy no. TEN10782 Received by L&I Effective date 07/13/2018 07/15/2018 Expiration date 07/15/2019 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&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. Workers' comp Do you know if the business has employees?If so,verify the business is up-to-date on workers'comp premiums. I&I Anr..nunt In Account is current. 178,628-00 Doing business as 3&3 ROOFING LLC Estimated workers reported Quarter 3 of Year 2018"11 to 20 Workers" L&I account contact T3/STEPHANIE HENDERSON(360)902-5598-Email:HSTE235@lni.wa.gov Public Works Strikes and Debarments Verify the contractor is eligible to perform work on public works projects. 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 07/09/2018 Under appeal.The results of the inspection are Inspection no. being challenged. 317949404 Date of appeal Location 1 012 5/2 01 8 1106 Ekle St Camano Island,WA 98282 •kc�s ��tashinoff".. HOp us improve 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:7620.00 17803 83rd Dr. NE Arlington, WA Project Address: Parcel ID#: Owner: Eddie Ness Address: 17803 83rd Dr. NE City:Arlington State: WA Zip Code:98223 Phone Number: 425-346-8988 Email:jennifersandsroofing@hotmail.com Applicant: S & S Roofing LLC Address: 104S. West Ave City:Arlington State: WA Zip Code:98223 425-346-8988 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 R918M M 8/3/2019 Contractor's License Number: Expiration: Type of Roofing Material: 260 pound per sq. Pabco 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,9ed, eme=,o=om Liz) � 12/24/2018 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 Address: 17803 83rd Dr NE Permit#:2323 Parcel#:00958500005100 Valuation:7620.00 OWNER APPLICANT CONTRACTOR Name:GREENSHAW LISA D Name:S&S Roofing LLC Name:S&S Roofing,LLC Address: 17803 83RD DR NE Address:104 S.West Ave Address:P.O.Box 969 City,State Zip:ARLINGTON,WA 98223-4039 City,State Zip:Arlington,WA 98223 City,State Zip:Marysville,WA 98270 Phone: Phone:360-386-9903 Phone:360-386-9903 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. IBC 110/IRC 110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of Arlington m �I be reported on v ur sales tax return form and coded City of Arlington#3101. Signature Print Name Date Rel se BU Date CONDITIONS Please call for final inspection. 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 12/26/2018 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 CITY OF ARLINGTON I 238 N. OLYMPIC AVE-ARLINGTON, WA. 98223 12 PHONE; (360)403-3551 BUILDING PERMIT Address.t7803 83rd Dr NE Permit#•2323 Parcel#:00958500005100 Valuation:7620.00 OWNER APPLICANT CONTRACTOR Name:GREENSHAW LISA D Name:S&S Roofing LLC Name:S&S Roofing,LLC Address: 17803 83RD DR NE Address:104 S.West Ave Address:P.O.Box 969 City,State Zip:ARLINGTON,WA 98223-4039 City,State Zip:Arlington,WA 98223 City,State Z.ip:Marysville,WA 98270 Phone: Phone:360-386-9903 Phone:360-386-9903 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City,State,Zip: City,State,Zip: Phone: Phone: LIC 4: EXP: LIC 11: 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'riIEREBY-, 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. IBC 11 OARC 110. SA_ LES TAX NOTICE:Sates tax relating to construction and construction materials in the City of Arlington must be reported on v ur sales tax return form �ad o�Cfli 1 e Print Name Date �RclG see B Date CONDITIONS Please call for final inspection. THIS PERMIT AUTHORIZE ONLY THE WORK NOTED THIS PERMIT COVERS WORK TO BE DONE ON PRIVATF.PROPERTY ONLY ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION. PERMIT FEES Date Description Fee Amount 1212612018 Processinglrechnology Fee $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 Permit#: 2323 Permit Date: 12/26/18 Permit Type: RESIDENTIAL RE-ROOF Project Nam e S& SRe Roof 17803 83rd Dr Applicant Nam a S& SRoofing LLC Applicant Address: 104 S. West Ave Applicant, City, State, Zip: Arlington,WA98223 Contact: Phone: 360-386-9903 Em al:jennifersandsroofing@hotm al.com Scope of Work: Re-Roof Non structural Valuation: 7620.00 Square Feet: 0 Num ber of Stories: 0 Construction Type: O xupancy G ioup: ID Code: Permit Issued: 12/27/2018 Permit Expires: Form Permit Type: Status: LASERFICHE Assigned To: Raelynn Jones Property Parcel# Address L egal Description O wrier Nam e Cvner Phone Zoning 00958500005100 1 7803 83RD DR NE GREENSHAW LISA 111 Single Fam iy D Residence-Detached Contractors Contractor P rim ay Contact P hone A ddress C ontractor Type L icense License# 104 S WEST CONSTRUCTION COA Business S&SROOFING LLC 3 603869903 602 934 849 AVE CONTRACTOR License S&SROOFING LLC 3 603869903 104 S WEST CONSTRUCTION Labor& SSROOSR918MM AVE CONTRACTOR Industries Fees Fee D escription N otes A in Cunt Processing/Technology $25.00 Total $ 25.00 Attached Letters Date L etter D escription 12/26/2018 Building Perm i Paym sits Date Paid By D escription P aym ait Type A ccepted By A m otnt 12/27/2018 Dana Johnson 7 3200086 c c $25.00 O ttstanding Balance $0.00 Uploaded Files Date File Nam e 12/27/2018 4358379-2323 Signed perm t.pdf 12/26/2018 4353475-2323 Apnlication.pdf