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HomeMy WebLinkAbout6119 209th St Ne_BLD5356_2023 Permit Packet Coversheet Community and Economic Development City of Arlington • 18204 59th Avenue NE • Arlington, WA 98223 • Phone (360) 403-3551 Page 1 of 1 Permit Number: Permit Type: Address/Parcel: Completed (Month/Year): Land Use ˆ Notice of Decision ˆ Staff Report ˆ Application ˆ Narrative ˆ Legal Description ˆ Vicinity Map ˆ Site Plan ˆ Landscape Plan ˆ Complete Streets Checklist ˆ Traffic Impact Analysis ˆ Snohomish County Traffic Mitigation Offer ˆ WSDOT Traffic Offer Form ˆ Tree Survey ˆ Stormwater Drainage Report ˆ Geotech Report ˆ Critical Area Evaluation Form ˆ SEPA Checklist ˆ Public Notice Material ˆ Noticing and Related Documents ˆ Water / Sewer Availability Certificate ˆ Unanticipated Discovery Plan Form ˆ Aerial Photo of Site ˆ Proposed Building Materials ˆ Lighting Plans and Lighting Cut Sheets ˆ Color Elevations ˆ Design Matrix ˆ Plat Map ˆ Title Report ˆ Lot Closures ˆ Preliminary Civil Plans ˆ Archaeological Survey o Confidential Documents. Contact the City to obtain. ˆ Topography (Existing Conditions) ˆ CC&R’s ˆ Deeds / Easements / Conveyances /Dedications ˆ Developer’s Agreement ˆ Recorded Copies ˆ Bonding or Assignment of Funds o Confidential Documents. Contact the City to obtain. ˆ Letters and Project Documents ˆ Other: Civil ˆ Issued Permit ˆ Application ˆ Other Applications ˆ Construction Calculation Worksheet ˆ Approved Plans ˆ Review Comment Form ˆ Letters and Project Documents ˆ Other Agency Permits ˆ Reports: o Drainage Report Pg: o Stormwater Pg: o Geotech Pg: o All Other Reports ˆ SEPA and Noticing Materials ˆ Inspections ˆ As-Builts ˆ Other: Building ˆ Issued Permit ˆ Application ˆ Additional Applications ˆ Approved Plans ˆ Site Plan ˆ Letters and Project Documents ˆ Calculations ˆ Project Specification Manuals ˆ Reports ˆ Certificate of Occupancy ˆ Inspections ˆ Other: BLD5356 Residential Re-Roof 6119 209th St Ne December 2023 ✔ ✔ RESIDENTIAL RE-ROOF PERMIT APPLICATION Community and Economic Development City of Arlington • 18204 59th Ave NE • Arlington, WA 98223 • Phone (360) 403-3551 I hereby certify that I am the Owner, Applicant, Contractor, and authorized to sign this application and that the above information is correct and construction on, and the occupancy and the use of the above-described property will be in accordance with the laws, rules and regulation of the State of Washington, and the City of Arlington. 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. Signature Print Name Date Property Address: Lot #: Parcel ID No.: Project Valuation: Project Scope of Work: Primary Contact: Owner Applicant Contractor Owner Name: Office No.: Email Address: Cell No.: Mailing Address: City: State: Zip: Applicant Name: Office No.: Email Address: Cell No.: Mailing Address: City: State: Zip: Contractor Name: Office No.: Email Address: Cell No.: Mailing Address: City: State: Zip: L&I Contractor License Number: Expiration Date: RE-ROOF INFORMATION Type of Roofing Material:Replacing existing sheathing: Yes NoNumber of Existing Layers: Installation over existing material: Yes NoRoof tear off: Yes NoClass of Roofing: A – Highest Fire Rating B – Moderate Fire Rating C – Light Fire Rating Class Examples:Concrete, Clay, Roof Tiles, Fiberglass Asphalt Composition Shingles, Metal Roofs Pressured Treated Shakes and Shingles Untreated Wood Shakes and Shingles, Plywood, Particleboard Provide additional information, as necessary: