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Home My WebLink About18400 Cedarbough Loop Rd_BLD004387_2025 (3) \A� INSPECTION REPORT Vv - tilN G?'O Permit No.: Lot#: Address: $4CO N Z Contractor: .� iO Owner: �� - S�INO Date: 17�0 l ❑ APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION �flRRECTION REQUESTED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ Please contact inspector. ❑ Was not able to perform inspection. ❑ CALL 435-0674 FOR RE-INSPECTION - 24 hour notice required. Date: Inspector: 4FPE�OF INSPECTION REQUESTED ❑ Under-floor ❑ Framing ❑ Gas Piping ❑ Footing ❑ Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Rough-in inal ❑ Wood Stove ❑ Insulation ❑ Masonry ❑ Drainage ❑ Other: INSPECTION REPORT 3 Lot#: —i 4ti1N G r� Permit No.: L �� LT' r�L Q• '� Address: Z Contractor. Owner, FIII� Date: ❑ PARTIAL PPROVAL CORRECTION REQUESTED ;t�-A ❑ ❑ VIOLATION roved. ❑ Corrections listed below MUST BE MADE before work can be app ❑ Please contact inspector. ❑ Was not able to perform inspection. -INSPECTION - 24 hour notice required. ❑ CALL 435-0674 FOR RE G Date: Inspector: PE OF INSPECTION REQUESTED Piping '),�(Gas r ❑ Framing Consultation ElUnder-tioo ❑ u Drywall, Nailing ❑ Footing ❑ Groundwork ❑ Foundation ❑ Shear Nailing ❑ Struct. Slab ❑ Grid p Final ❑ Mechanical ❑ Rough-in El Wood Stove ❑ DrainageRough-in ❑ Insulation ❑ Masonry ❑ Other: city od AltUng,rom NOTICE and Inspection Report zi Address U J yt c� !yr d Cx 1 •�[3�- Contractor Owner I Requested by TYPE OF INSPECTION REQUESTED 13 C`Cf ❑ MECH:Pmt. No. ,,BLDG: Pmt.No. ` ❑ PLBG: Pmt.No. ❑ Framing `I El Footing �Final El Foundation ❑ Drywall Nailing ❑El ConcreteConcrete Slab [I Other ❑ Fireplace and Chimney ❑ Furnace APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. � ❑ APPROVED FOR OCCUPANCY subject to certificate of occupancy. ❑ Work listed below has been inspected and approved. ❑ Please contact inspector and arrange for appointment. ❑ Was not able to perform inspection. ❑ CALL 435-5785 FOR REINSPECTION — 24 hour notice required. ------------------------------------------------- Date J Inspector I was present during this inspection. City 06 ARLINGTON NOTICE and Inspection Report Address Contractor Owner Requested by TYPE OF INSPECTION REQUESTED ❑ MECH:.Pmt. No. ❑ BLDG:Pmt.No. ❑ PLBG: Pmt. No. ❑ Footing ❑ Framing El Nailing El Final ❑ Foundation Rough-in El Roug ❑ Concrete Slab ❑ Other ❑ Fireplace and Chimney ❑ Furnace D- APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ APPROVED FOR OCCUPANCY subject to certificate of occupancy. ❑ Work listed below has been inspected and approved. _ ❑ Please contact inspector and arrange for appointment. ❑ Was not able to perform inspection. ❑ CALL 435-5785 FOR REINSPECTION —24 hour notice required. Date Inspector I was present during this inspection. cityot .:IEIAINGT40N NOTICE and Inspection Report Address w\ Contractor Owner Requested by TYPE OF INSPECTION REQUESTED 'kr'BLDG: Pmt. No. ❑ MECH: Pmt. No. ❑ PLBG: Pmt.No. ❑ Footing ❑ Framing ❑ Foundation `❑_Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough-in ❑ Fireplace and Chimney ❑ Furnace ❑ Other ❑ APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ APPROVED FOR OCCUPANCY subject to certificate of occupancy. ❑ Work listed below has been inspected and approved. ❑ Please contact inspector and arrange for appointment. ❑ Was not able to perform inspection. ❑ CALL 435-5785 FOR REINSPECTION —24 hour notice required. Date Inspector I was present during this inspection. Permit Nc NOTICE and rtspection Report Date Called 3.� Address l �UU Time Called f Contractor B Owner �D'4 Y Requested by T� >> TYPE OF INSPECTION REQUESTED ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm ❑ Gas Piping ❑ Footing Framing ❑ Woodstove Drywall Nailing ❑ Final ❑ Foundation ❑ � ❑ Concrete Slab ❑ Rough-In Plumbing ❑ Reinspection ❑ Shear Wall ❑ Furnace ❑ Others APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTI UIRED ❑ Corrections listed below MUST BE MADE before wo n be approved. �ork listed below has been inspected and appr ❑ Please contact inspector and arrange for app intment. ❑ Was not able to,perform inspection. ❑ CALL 435-5g66.4--OR REINSPECTION—24 hour 1 Date Inspector I was present during this inspection. Lilt, q IN'I:T11` Permit No. ^1 NOTICE and ini-spection Report 7 f f _t n Date Called "l Address Time Called Contractor By Owner Requested by TYPE OF INSPECTION REQUESTED ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm ❑ Gas Piping ooting ❑ Framing ❑ Woodstove �undation ❑ Drywall Nailing ❑ Final ❑ Rough-In Plumbing ❑ Reinspection ❑ Concrete Slab ❑ Shear Wall ❑ Furnace ❑ Other— APPROVAL ❑ PARTIAL APPROVAL ❑ CORRECTION REQUIRE ❑ VIOLATION ❑ Corrections listed below MUST BE MADE before work can be approved. ,,Work listed below has been inspected and approved. Please contact inspector and arrange for appointment. ❑ Was not able to perform inspection. ❑ CALL 43O5-FOR REINSPECTION—24 hour notice required. ----------------------------------------------------------- 07 Date i was present during this inspe Inspector ction. r )/�;O-Zi � Cih, ., A1 uNlivrON Permit No. NOTICE and Inspection Report Date Called Address Time Called Contractor By Owner 1, Requested by a �-�✓'' TYPE OF INSPECTION REQUESTED ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm ❑ Gas Piping ❑ Footing ❑ Framing ❑ Woodstove ❑ Foundation ❑ Drywall Nailing Final ❑ Concrete Slab ❑ Rough-In Plumbing ❑ Reinspection ❑ Shear Wall ❑ Furnace ❑ Other— APPROVAL J ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. Dki Work listed below has been inspected and approved. ❑ Please contact inspector and arrange for appointment. ❑ Was not able to pe rm inspection. ❑ CALL 435 Y. OR REINSPECTION—24 hour notice required. Date s Inspector �...pre nt during this inspection. /j) AL It1A1'0�ThN Permit No. _ L / -NOTICE and Inspection Report Date Called Address Time Called �2 Contractor 12 By Owner Requested by TYPE OF INSPECTION REQUESTED Insulation ❑ Setback ❑ Reroof ❑ Gas Piping ❑ Plumb GW ❑ Roof Diaphragm ❑ Woodstove ❑ Framing ❑ Footing ❑ Final ❑ Drywall Nailing ❑ Foundation ❑ Reinspection Concrete Slab ❑ Rough-In Plumbing ❑ ❑❑ Furnace Other_ ❑ Shear Wall PARTIAL APPROVAL APPROVAL � CORRECTION REQUIRED VIOLATION listed below MUST BE MADE before work can be approved. ;>oo,,ec',ons rk listed below has been inspected and approved. Please contact inspector and arrange for appointment. ❑ Was not able to pe orm inspection. CALL 43 A OR REINSPECTION—24 hour notice required. Date Inspector I—C�"lw.asp,.s.nld.rin�g,,,s.n�.pecrion. City q i��IAM, rON NOTICE and Inspection Report Address Contractor Owner Requested by TYPE OF INSPECTION REQUESTED XBLDG: Pmt. No. �J ❑ MECH: Pmt. No. ❑ PLBG: Pmt. No. .Footing ❑ Framing Foundation ❑ Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough-In ❑ Fireplace and Chimney ❑ Furnace ❑ Other APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ APPROVED FOR OCCUPANCY subject to certificate of occupancy. ❑ Work listed below has been inspected and approved. ❑ Please contact inspector and arrange for appointment. ❑ Was not able to perform inspection. ❑ CALL 435-5785 FOR REINSPECTION —24 hour notice required. Date Inspector I was present during this inspection. �3 ! � j _ * � � t 1 � o fr t � 1 z: 4C'l m _ s 7^y - � j 'G CIO/ KgViM I I OCIO)ALK COW. =0 IM AVL SL B WWWWWO WA UM CITY aF ARL I N0Y0h! CONOY RUCT I ON P'E RM I-r gDeE RM I T No-- 010—A+3a? Owner: GUTIERREZ, TONY 18400 N CEDARBOUGH LP ARLINGTON 98223 Value of Work: $350.00 Tax ID: 7385-004-042-0002 phone: 435-E680 Describe Work: FIREPLACE INSERT Proposed Use: RESIDENTIAL Legal Description: Job Address: 18400 N CEDARBOUGH LP Contractor's Na.e Type Address License# DAVES INSTALLATION MEC 1110 BROADWAY DAVESI105ON5 -- -- __ P E R M I T F E E S - - - I Equipment and Fixtures Number --Fee--- Total Charge --------------------------------------- ------ - t METAL F I REPLACE & CFI I MNEY i 8 i i.00 GAS PIPING 1-4 OUTLETS I YC1. 00 1 S U B T 0 T A L...... J $17.00 TOTALS - Fee Equipment $17.00 Mech Permit $24.00 SI6NATURE: _ TOTAL FEE................. $41.00 1 HEREBY CER t 1 riA' READ AND EXAMINED HIS ML (DTI tJ AND PAYMENTS.... . .............$0.0 KNOW THE SAME TOP TRUE - COR- RECT ALL PROVI S OF LAWS AND TOTAL DUE................ . $41.08 GRDiWANCES GOVER14ING T I �-c OF WORK WILL BE I WHETHER z:'�-E L F:Ey DATE RECEIPT # H LDI�i ,tF: ICIAL �j CITY OF ARLINGTON CONSTRUCTION PERMIT -' �❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO. j a,NLR P//pIi,cci l MAIL ADDRESS / / I CI1/Y / I ZIP �?� PHONE ` G I.cJ (o-Y! rY/ ��`(U(7 /4 �, ✓ I L, /"TY11r�.tt�l/� 9 ! ARCIi1T CT OR DESIGNER MAIL AUURESS j CITY ZI► PHONE G NERAI CUN RAC UR r MAIL ADD�S$ / � CITY LIP efZ�l PHONE LIC NSE/ MLCi+ANICAI CUN1RACiOR hiAll AUURESS CITY ZIP PHONE LICENSE I PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE/ to ASS OF WORK AL N(,W ❑AUDITION TERATION El REPAIR ❑UEMULI LION ❑BUILUING RELOCATION EL Al ION OI WORK LLJ J �OGa LRIBL WORK m PRUPUSI U US O/ BUILUING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- Z LL"-�jIJ- S(RIPIIONUI PROPLRTY(St"N BELOW OR ATTACH FOUR COPIIS) __,1 SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK -j LOP L RLOCK • Or WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE Q GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITYTO lu VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR TAX.I UMBER FROM PROPERTY TAX STATEMENT LOCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF '�� CONSTRUCTION.PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE. O SIGNATURE OF CONTRACTOR OR AUTHORI ZED AGENT DATE IU •UURLSS ' / (OPPICE Usti ONLY) PLUMBING MUCHANICAL NO. TYPD OP PUCrURE PER :i PIXTURES NO. TYPE OF EQUIPMENT PEB :'.PIXTURLTS ATER CLOSIT ILEI IR COND.UNITS-TI.P. P.A. + d .Ilst•" ATIlTUO EPRICERATION UNITS-II.P.EEA. W .Ilr•" �_ .AVATORY(WASH BASINS _ OILERS-ILP.EA. T d .list•• IIOWEIL JASPIRBDA.C.ONrrS-TONNAOEEIA. pultdim.list•• ITCHEIN SINK A DISPOSAL PORCPD AIR SYSTEMS-D.T.U. MEA ISIIWASHER ALL I IRATBRS—D.T.U. M _ _AUN DRY TRAY 1UN IT I WATERS—B.T.U. M LOTHES WASHEIR IVAPORATIVECOOLEtS ATER IMATTER :LOTIIPS DRYERS RINAL _ P1,17'ILATION PAN )RINKINO POUNTAIN IMGBIIOOD COMMERCIAL 'LOOK DRAIN IR IIANDLINO UNIT- CPM VACUUM BREAKERS OVE (i /,A OOP DRAINS-RAINLEADERS ImarrAL PIRBPLACH A CHIMNEY INK(SERVICE,-BAR,In-C. ATBR"RATER AS NPINO •u to S-t).00.mddnl.-S.7S -Equipment list must be provided SUB T"OTAL SUB TOTAL PFAMIT PERMIT TOTAL PPP TOTAL PISS SIUL YARD SL i NACX SIRLLI SL I BALK RLAR YARD SETBACK PLAN CIILCK NUMBER PLAN CHECK FEE FEE RECEIPT NO. USl /ON[ LOT AREA VACANT SITE ❑YES ❑NO FEES VALUATION FEE IYPL UE CONS] OCCUPANCY GROUP NO.Of DWELLING UNITS PLAN CHECKING VG SI/.L OI (ILOC.. NO.or STURiLs MAX.000.LOAD BUILDING f PLUMBING r IRE SPRINKLERS REQUIRED ❑YES ❑NO MECHANICAL COMMENTS STATE BLDG.CODE ENERGY CODE SURCHARGE PENALTY U.B.C. SEC.3031a1 WATER/SEWER FEES TOTAL PERMIT VALIDATION WHEN PROPERLY VALIDATED IIN THIS SPACE)THIS IS YOUR PERMIT 6 RECEIPT PAID CRR BY cc-ASSESSOR,APPLICANT.TREASURER,BLDG DEPT. oUaOirx:grnont DATE RECORDS COPY CITY OF ARLINGTON CONSTRUCTION PERMIT ® COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO.0042 OWNER MAIL ADDRESS CITY ZIP PHONE bale & Diane Berry 18400 N. Cedarbough Arlington, WA 98223 435-6278 ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PH N K & B Designing 16212 Bothell Way SE Millcreek WA 98102 �37-1076 GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LIC NSE Kevin Stockdale Const. 820 83rd Ave SE #3 Everett, WA 98205 334-4106 (KEVIN Cl MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N CLASS OF WORK ❑NEW [3 ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑BUILDING RELOCATION VALUATION OF WORK $ 20FOQQ DESCRIBE WORK Install French doors, construct kitchen nook., add deck,reconstruct existing deck PROPOSED USE OF BUILDING Kitchen Nook I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- LLGAL DESCRIPTION OF PROPERTY(SHOWN BELOW OR ATTACH FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK LUI D42 BLOCK OF Woodlands Sector I WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE GRANTING OFA PERMIT DOES NOT PRESUMETO GIVE AUTHORITYTO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR TAX ID NUMBER LOCAL LAW REGULATING CONSTRUCTION OFTHE PERFORMANCE OF 7385-OQ4--0.42•-0.00.2 CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE. SIGNATURE \TRAC�,OROR AUTHORIZED jAGENT DATE IOB ADDR(SS c 18400 N. Cedarnough (OFFICE USE ONLY) MECHANICAL PLUMBING NO. TYPE OF FIXTURE FEE NO. TYPE OF EQUIPMENT FEE 1 WATER CLOSET (TOILET) 2 00 AIR COND_UNITS —H.P. EA BATHTUB 2 GO REFRIGERATION UNITS—HP. EA LAVATORY (WASH BASIN) 4 GO BOILERS —H.P.EA SHOWER 2 100 GAS FIRED A.C.UNITS—TONNAGE EA KI ICHEN SINK& DISP. FORCED AIR SYSTEMS— B.T.U. MEA UISFiWASIiER WALL HEATERS— B.T.U. M LAUNDRY TRAY UNIT HEATERS— B.T.U. M CLOTHES WASHER EVAPORATIVECOOLERS W'AI ER HEATER CLOTHES DRYERS URINAL VENTILATICN FAN DRINKING FOUNTAIN RANGE HOOD COMMERCIAL FLOOR DRAIN AIR HANDLING UNIT— CPM VACUUM BREAKERS STOVE ROOF DRAINS - RAINLEADERS METAL FIREPLACE&CHIMNEY SINK (SERVICE — BAR,ETC) WATER HEATER GAS PIPING SUBTOTAL S 10, 0.0 SUB TOTAL $ PERMIT $ 15 00 PERMIT ; TOTAL FEE ; 25 00. TOTAL FEE ; SIDE YARD SE IBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE FEE RECEIPT NO USEZ_ONE LOT AREA VACANT SITE 7-19-'90 134. 55 22496 ❑YES ❑NO FEES VALUATION FEE TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS PLAN CHECKING NG V--N R3 & M BUILDING ; 207 OO SIZE OF BLDG. NO.OF STORIES MAX.00C.LOAD PLUMBING 25 00 FIRE SPRINKLERS REQUIRED ❑YES ❑NO MECHANICAL COMMENTS STATE BLDG.CODE 4 50 ENERGY CODE SURCHARGE PENALTY U.B.C. SEC.303(a) PAIDI, WATEWSEWER FEES SEP I1199O TOTAL 236 50 PERMIT VALIDATION WHEN PROPEN VALIDATED (IN THIS SPACE)THIS IS YOUR PERMIT&RECE PAID CR# Y cc:ASSESSOR,APPLICANT,TREASURER, BLDG. DEPT. 8U FRC1At DATE RECORDS COPY E $�iIfro. OP." OF ARLINGTON CONSTRUCTION PERMIT ® COMBINATION BUILDING Q MECHANICAL ❑ PLUMBING SIGN PERMIT NO. ' OWNER MAIL ADDRESS CITY ZIP PHONE �/ , Ma le_4- "D R61 )i f$`ItO At. ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LIC NSE# 5 Cou.4'- �l MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE/ PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N CLASS OF WORK NEW ADDITION ❑ALTERATION ❑REPAIR EDEMOLITION BUILDING RELOCATION VALUATION OF WORK s L-2cOcc) DESCRIBE WORK c1(i�r' �PRUPUSt U USE OF BUILDING 411 I HEREBY CERTIFY THAT I HAVE READ AND EXAMI ED THIS APPLICA- LLGAL DESCRIPTION OF PROPERTY(SHOWN BELOW OR ATTACH FOUR COPIES) TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK LDI PY2 BuxK27V OF °Gd/000'c% r.1`o- WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE GRANTING OFA PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO 00�/--d�,/Z-(,Cj. VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR TAX ID NUMBER LOCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF CONSTRUCTION.PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE. 108 AUDRLSS SIGNATUREPGFCONTRACTORORAUTHORIZEDAGENT DATE 0'02Alv ' uv,v x vex/�� / --9'c (OFFICE USE ONLY) PLUMBING MECHANIC L NO. TYPE OF FIXTURE FEE NO. TYPE OF EQUIPMENT FEE WATER CLOSET (1UILET) AIR COND'UNITS -H P. EA. BAIHIUB REFRIGERANON UNITS-H.P.EA. LAVATORY (WASH BASIN) BOILERS-H.P. GAS FIRED A.C. UN\--S-TONNAGE EA. KI ICHLN SINK& DISP. FORCED AIR SYSTEMS`- B.T.U. MEA DISHWASHER WALL HEATERS-B.T.U. M LAUNDRY TRAY UNIT HEATERS- B.T.U. \ M CLOIIIES WASHER EVAPORAI IVE COOLERS WAIERHEATER CLOTHES DRYERS URINAL VENTILATICN FAN DRINKING FOUN IAIN RANGE HOOD COMMERCIAL FLUOR DRAIN AIR HANDLING UNIT- CPM VACUUM BREAKERS STOVE ROOF DRAINS - RAINLEADERS METAL FIREPLACE&CHIMNEY SINK (SERVICE - BAR,ETC.) WATER HEATER GAS PIPING SUBTOTAL $ O SUB TOTAL $ PERMIT s PERMIT $ \ TOTAL FEE $ TOTAL FEE $ SIDE.YARD SE 1 BACK STRLET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE FEE XECEIPT NO. USE ZONE D L T AREA � VgCANT SITE__j YES ❑NO FEES VALUATION FEE TYPE OF C N T. OCCUPANCY GROUP v! ' 0.OF DWELLING UNITS PLAN CHECKING NG SIZE OF BLDG. NO.OF STORIES MAX.OCC.LOAD BUILDING $ O�1 J f PLUMBING Z " FIRE SPRINKLERS REQUIRED J ❑YES NO MECHANICAL COMMENTS STATE BLDG.CODE ,✓ ENERGY CODE SURCHARGE �Q PENALTY U.B.C. SEC.303(a) WATER/SEWER FEES TOTAL PERMIT VALIDATION WHEN PROPERLY VALIDATED IIN THIS SPACE)THIS IS YOUR PERMIT b RECEIPT PAID CR# BY Pec 1 gm cc:ASSESSOR,APPLICANT,TREASURER D BUILDINGOFFICi4L DATE RECORDS COPY (� m m Z Z D --I cn c 0 D —1 cn r 11 m D v O Q 2 Q ' 1 O O Q O N' m m 0 c4 f n D m m o, o ° H W m Q- _ s 3 o o V) D Z �'`Q fl p 7 O' O LA w r Q Y N T 3 m m m o o. Q cQ c Cl CD 0 0' o fD O N 3 �, Q Z Q_ „ = m o 3' N o 3' 0 0 N s O X- o o ° 'Q Q C n m n c n n O Q m 7 (� CD C• (�D CD o _ ul, D s ° CDw C Q Z Q Z m CD•� .� Cl m O m : fD n Q 3 A 2 T ° Q o �, �, Q n O CD CD 0 NO m 3 C 7 L Q' =-, Z \ CCD ° `n O - $ ° < _' O 0coO Z m 0 Q CD 3 — C Q N /� Q• _ Q = m O V, 7 CA -0 CD Q c = Z Z Q a Q - l l o n CD O O �. Q Q c Z Q ❑ ❑ N 0 o CD m _ O ? °• ° Q < a a Q a s 3 5 s Q3 _ —_ � � D Q' N O Q J < O N N N N a- I _ _0 m p N V N N N cc n = m — O CD (A(Ao 0 fD 3 Z — CD _O O = Q n (�c,J1(\� Q 4 Q 0 0 o s fi o 03 o °, c' C o c n ,r \ Q a z Q o < _ � z � m = m � Q ° l o \ a Q = z r0 C m` °, p t _ CDD t '11 2 n c O o =to � -r � T v "' Q S > 03Q W o ' x o`. o _2. � cD a:p � a 3 1 T p 10 N n a Tcr � Q c <Q Q N rn = w N p m �' Q Q Q Z m CA Z Q Q Q ° Q m �• °�- co a- o D �° Q o D Q jm CD o 'Q o o T. ° 4 m G N o o �- = o O s Q Q Q Q n 3 Q- 3 �'r CDm o' O Q N' m N m n m n. S to m m �j�� ID S Q I S Q V V� C Q m cQ s ❑ uv, uvi cop < N �J O J 7 ' < :3 Q c O < v /c N M 02 S D l ) j O Q X T m a m f4 O "6 m 3 2 Q (� 5 �. _• o w D O 6q O c ? nS Z Z Q Q = N ElcQ = Q (AFD N O D O a v Z • ry g T G< 7C m T T A rn M 'O O � Q c G p r O x O Lf o m 7 Q s o C � Z m CD SI n m Q c m m ° T rn 3 f o 3 C CD 3 Z N N' Q_ O m 0- S = Q 0 I tr m m Z CA 2 f m m 7• � _ � = m m � O 0 N. O - - `= m N. O O N m O0 el n N_ Q c N Q Q m 0 c 0 Q_ Q_ PLOT PLAN FOR DEPARTMEN USE Draw below,to scale, a plot plan showing: FOR DEPARTMENTAL USE Application for Certificate of Zoning Compliance ❑ Checked Initials 1. Dimension and shape of the lot. 1. 2. Front street name. 2. Building Permit Certificate of Occupancy ❑ checked and approved. 3. Side street name if corner lot. 3. 111 4. Sizes and location on the lot of buildings already existing. 4. SS G 5. Location and dimensions of proposed building or alterations. 5. Building Inspector. Date 6. Front yard,side yard,rear yard setbacks. 6. 7. Locate and describe any fences,walls,hedges,signs, 7. Issued Building Permit No. T Dote O front yard trees and shrubs,green belt. 8. Location and size of required off-street parking and loading. 8. INSPECTION RECORD Inspection Date Signature Set Back Excavation Concrete Reinforced Steel Grout Blocks r; Bond Beam Frame Roofing Room Ventilation Kitchen Vent Bathroom Vent Foundation Vent Access Hole Garage Fireproofing Fireplace U` Spark Arrester Water Closet Water Heater Sewage Disposal Lathing Plastering Correction Order Left Stop Work Order Issued Stop Work Order Released Give brief report of special or unusual conditions Job completed Date Building Inspector Certificate of Zoning Compliance No. Issued Date Certificate of Occupancy No. Issued Date MOORE BUSINESS FORMS INC LA