HomeMy WebLinkAbout18406 E Country Club Dr_BLD575_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: Residential 0 Commercial Valuation: 19430
Project Address: 18406 E Country Club Dr
Owner: Alan Goldberg
Address 18406 E Country Club Dr
City: Arlington State: WA Zip: 198223
Phone Number: 425-315-1515 Date: 02/04/15
Email: kevinj@america1 stroofing.com
Contractor Information
Contractor Name: America 1st Roofing
Address 12503 Evergreen Dr
City: Mukilteo State: WA Zip: 98275
License Number AMERl1R056BU Expiration: 12/31/15
Type of Roofing COMPOSITION No. of Existing 11
Material: Layers:
Class of Roofing: A 0 B 0 C
Replacing existing 0 Yes No Roof tear off: Yes 0 No
sheathing:
Application over 0 Yes No
existing material:
The following is required for NON-Residential Buildings:
• Existing roof structure and material:
Shake Roof with OSB sheathing
• Two copies of the installation specifications and U.L. listed roof assembly.
• Occupancy of Building:
Please attach plans or other supporting documents:
By submission of this form, 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.
CITY OF ARLINGTON
238 N. OLYMPIC AVE - ARLINGTON, WA. 98223
PHONE; (360) 403-3551
BUILDING PERMIT
Address: 18406 E Country Club Drive Permit#:575
Parcel#:00832900005800 Valuation: 19430.00
OWNER APPLICANT CONTRACTOR
Name:GOLDBERG ALAN D&SHERYL,K Name: Amercia Ist Roofing Name:Amercia Ist Roofing
Address: 1301 E BROWARD BLVD UNIT 330 Address:12503 Evergreen Drive Address: 12503 Evergreen Drive
City,State Zip: FORT LAUDERDALE,FL 33301 City,State Zip:Mukilteo,WA 98275 City,State Zip:Mukilteo,WA 98275
Phone: Phone:425-3 15-15 15 Phone:425-315-1515
MECHANICAL CONTRACTOR PLUMBING CONTRACTOR
Name: Name:
Address: Address:
City,State,"Zip: City,State,Zip:
Phone: Phone:
LIC#: FXP. LIC#: EXP:
JOB DESCRIPTION
PI{RNIIT TYPE: Residential Re-Roof CODE YEAR: 2012
STORIES: CONST.TYPE:
DWELLING UNITS: 1 OCC GROUP:
BUILDINGS: 1 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 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]10/IRCI 10.
SA LES TAX NOTICE:Sales tax relating to constriction and construction materials in the City of rlii ton must be reported on your sales tax return form
and coded City of Arlington#3101, C
2
1Sienature Print Name Date Released By Date
CONDITIONS
If sheathing needs replacement, call for 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
Total Due: S0.00
Total Payment: S0.00
Balance Due: $0.00
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#: 575
Permit Date: 02/05/15
Permit Type: RESIDENTIAL RE-ROOF
Project Name: Goldberg
Applicant Name: Amercia 1 st Roofing
Applicant Address: 12503 Evergreen Drive
Applicant, City, State, Zip: Mukilteo,WA 98275
Contact: Kevin
Phone: 425-315-1515
Email: kevinj@americalstroofing.com
Scope of Work: Re-roof
Valuation: 19430.00
Square Feet: 0
Number of Stories: 0
Construction Type:
Occupancy Group:
ID Code:
Permit Issued: 02/05/2015
Permit Expires:
Permit Form Type:
Civic Plus Number:
Status: COMPLETE
Assigned To: Latina Black
Property
Parcel# Address Legal Description Owner Name Owner Phone Zoning
00832900005800 18406 E COUNTRY CLUB GOLDBERG ALAN 111 Single Family
DR D&SHERYL K Residence-Detached
Contractors
Contractor Primary Contact Phone Address Contractor Type License License
#
Amercia Ist Roofing Kevin 425-315-1515 12503 Evergreen CONSTRUCTION
Drive CONTRACTOR
Attached Letters
Date Letter Description
02/05/2015 Building Permit
Uploaded Files
Date File Name
02/05/2015 950303-575 Issued Permit.pdf
02/05/2015 949271-18406 Re-Roof Permit Application response.pdf