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HomeMy WebLinkAbout17607 84TH AVE NE_BLD2929_2026 CITY OF ARLINGTON 238 N. OLYMPIC AVE - ARLINGTON, WA. 98223 PHONE; (360) 403-3551 BUILDING PERMIT Address:17607 84th Ave NE Permit#:2929 Parcel#:00958500003700 Valuation: 10175.00 OWNER APPLICANT CONTRACTOR Name:BROSSARD.fEFFREY B&LISA N Name:[Company Name] Name:S&S Roofing,LLC Address: 17607 84TH AVE NE Address:[Company Address] Address: 104 S West Ave City,State Zip:ARLINGTON,WA 982234050 City,State Zip:Arlington City,State Zip:Arlington,WA 98223 Phone: Phone:3603869903 Phone:3603869903 LIC:SSROOSR918MM EXP:08;03t2021 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 HISIHER 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 110tiRC110. SALES TAX NOTICE:S,Ics tax relating to construction and construction materials in the City of Arlington must be reported on your sales tax return form odcd City of Ar' to #3101. � C, 12/10/2019 igrtaw Print Name Date aleased BeDate 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 12/10/2019 Process!ng/Technology Fee $25.00 Total Due: $25.00 Total Payment: $0,00 Balance Due: S25.00 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 fth6 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:10,175.00 17607 84th Ave NE Arlington, WA 98223 Project Address: - Parcel ID#: owner: Jeff Brossard Address: 17607 84th Ave NE City:Arlington State: W4 Zip Code:98223 Phone Number: 425-244-1445 Email:jenn, rsandsroofing@hotmaii.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 R918M M 8/3/21 Contractor's License Number: Expiration: Type of Roofing Material: Pabco Premier Architectural 30 Number of Existing Layers: 1 Class of Roofing: A ✓1 B ❑ C ❑ Replacing existing sheathing: Yes ❑ No a 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. r ��actrr � �%lt�t<Zoot 12/10/2019 Applicants Signature Date Dana Johnson Print Applicants Name FOR STAFF USE ONLY DEC 10 2019 Permit# A od f3 ��`_ Amount Received Receipt# Date Received i i Awa,nmgro�sroi:gmammmi or Labor&Industries(fps://Ini.wa,ggy) Contractors 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 I 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. 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. TEN23542 Received by L&I Effective date 07/11/2019 07/15/2019 Expiration date 0 711 5/2 020 Insurance history Savings - No savings accounts during the previous 6,' )eriod. 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. Certifications & Endorsements OMWBE Certifications No active certifications exist for this business. Apprentice Training Agent 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 3 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 & Health Check for any past safety and health violations found on jobsites this business was responsible for Inspection results date 0 5/0 812 0 1 9 Violations Inspection no 317954022 Location 2629 NE 82nd St Seattle,WA 98115 Inspection results date 07/09/2018 Violations Inspection no. 317949404 Location 1106 Ekle St Camano Island,WA 98282 ��•� f 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: 10,175.00 17607 84th Ave NE Arlington, WA 98223 Project Address: Parcel ID#: Owner: Jeff Brossard Address: 17607 84th Ave NE City:Arlington State: WA Zip Code:98223 Phone Number: 425-244-1445 Email:jennifersandsroofing@hotmail.com Applicant: S & S Roofing LLC Address: 104S. 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: Pabco Premier Architectural 30 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� 12/10/2019 Applicants Signature Date Dana Johnson Print Applicants Name FOR STAFF USE ONLY Permit# Accepted By Amount Received Receipt# Date Received i NOTICE TO PERMITEE AND/OR OWNER ❑ PARTIAL APPROVAL Cl CORRECTIONS REQUIRED ❑ DO NOT OCCUPY OAPPROVED PERMIT#: 'Zg0'q M M DATE: .2, 1.Z( 20 OB ADDRESS: 04V LOT#: PROJECT: Fz I TYPE OF INSPECTION: Q-�jC%1 Elm OTHER: ❑ NO PERMIT-STOP WORK-OBTAIN PERMIT ❑ CONSTRUCTION IS NOT IN ACCORDANCE WITH APPROVED PLANS AND PERMIT -STOP WORK ❑ STOP WORK UNTIL AUTHORIZED TO CONTINUE BY INSPECTOR. ❑ CORRECTIONS LISTED BELOW MUST BE MADE BEFORE WORK CAN BE APPROVED. ❑ WORK NOT READY FOR INSPECTION:$50 REINSPECTION FEE(PER IBC) MUST BE PAID PRIOR TO NEXT INSPECTION. ❑ CONTACT INSPECTOR 360-403-3551 ❑ CALL FOR REINSPECTION /�p1�P�uG-� NoTC No E�T�. To fz� YAe-D Azc- oTk&)L i r e Ap,,� Ae� THE ACTIONS OR CORRECTIONS INDICATED ABOVE ARE REQUIRED WITHIN DAYS OR PENALTIES IMPOSED BY LAW MAYAPPLY. FOR INSPECTION CALL: 360-403-3417 INSPECTOR DAT LDS ti 0,, O PLANNING O CIVIL BUILDING CITY OF ARLINGTON �c NOTICE TO PERMITEE AND/OR OWNER ❑ PARTIAL APPROVAL ❑ CORRECTIONS REQUIRED ❑ DO NOT OCCUPY Z APPROVED PERMIT#: &0-z�oq DATE: I .Z1.2-OZ iD JOB ADDRESS: ] CA -0 ` LOT#: PROJECT: TYPE OF INSPECTION: �n FdAi OTHER: ❑ NO PERMIT-STOP WORK-OBTAIN PERMIT ❑ CONSTRUCTION IS NOT IN ACCORDANCE WITH APPROVED PLANS AND PERMIT -STOP WORK ❑ STOP WORK UNTIL AUTHORIZED TO CONTINUE BY INSPECTOR. ❑ CORRECTIONS LISTED BELOW MUST BE MADE BEFORE WORK CAN BE APPROVED. ❑ WORK NOT READY FOR INSPECTION:$50 REINSPECTION FEE(PER IBC) MUST BE PAID PRIOR TO NEXT INSPECTION. ❑ CONTACT INSPECTOR 360-403-3551 ❑ CALL FOR REINSPECTION fay y YALD Al/ n7�lf>Z THEACTIONS OR CORRECTIONS INDICATED ABOVEARE REQUIRED WITHIN DAYS OR PENALTIES IMPOSED BYLAW MAYAPPLY. FOR INSPECTION CALL: 360-403-3417 /G%/�L' INSPECTOR DAT LET Y 0,. 0 PLANNING Cl CIVIL /BUILDING CITY OF ARLINGTON CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360) 403-3551 BUILDING PERMIT i Address:17607 84th Ave NE Permit#:2929 Parcel#:00958500003700 Valuation: 10175.00 OWNER APPLICANT ` CONTRACTOR Name:BROSSARD JEFFREY B&LISA N Name:[Company Name] Name:S&S Roofing,LLC Address: 17607 84TH AVE NE Address:[Company Address] Address: 104 S West Ave City,State Zip:ARLINGTON,WA 98223-4050 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. -4- 12/10/2019 Signature Print Name Date 66leased B 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 12/10/2019 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#: 2929 Permit Date: 12/10/19 Permit Type: RESIDENTIAL RE-ROOF Project Name Brossard Applicant Nam a S& SRoofing LLC Applicant Address: 104 S West Ave Applicant, City, State, Zip: Arlington Contact: Phone: 3603869903 Em al: danasandsroofing@hotm al.com Scope of Work: Re-Roof Non structural Valuation: 10175.00 Square Feet: 0 Num ber of Stories: 0 Construction Type: O xupancy G ioup: ID Code: Permit Issued: 12/11/2019 Permit Expires: Form Permit Type: Status: LASERFICHE Assigned To: Raelynn Jones Property Parcel# Address L egal Description O wner Nam e Cvner Phone Zoning BROSSARD 00958500003700 1 7607 84TH AVE NE JEFFREY B&LISA Residence Single Dam iy sidence-Detached N 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 axnt Processing/Technology $25.00 Credit Card Service $0.75 Total $ 25.75 Attached Letters Date Letter D escription 12/10/2019 Building Perm i 12/10/2019 Building Penn Paym acts Date Paid By D escription P aym ant Type A ccepted By A m aunt 12/11/2019 Dana Johnson 7 8227245 $25.00 12/11/2019 78227245 C C Surcharge R aelynn Jones $0.75 O ttstanding Balance $0.00 Uploaded Files Date File Nam e 10/11/2021 9867279-2929 IC 1.27.2020.pdf 12/10/2019 5976019-2929 Application.pdf CITY OF ARLINGTON 238 N. OLYMPIC AVE - ARLINGTON, WA. 98223 PHONE; (360) 403-3551 BUILDING PERMIT Address:17607 84th Ave NE Permit#:2929 Parcel#:00958500003700 Valuation: 10175.00 OWNER APPLICANT CONTRACTOR Name:BROSSARD JEFFREY B&LISA N Name:[Company Name] Name:S&S Roofing,LLC Address: 17607 84TH AVE NE Address:[Company Address] Address: 104 S West Ave City,State Zip:ARLINGTON,WA 98223-4050 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 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:S le s tax relating to construction and construction materials in the City of Arlington must be reported on your sales tax return form oded City of At' o #3101. /0r - S rr— 1 10 19 ignatur Print Name Date 09leased B 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 12/10/2019 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