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HomeMy WebLinkAbout5529 Cemetery Rd_BLD025122_2025 INSPECTION REPORT ¢ti1N G TO Permit No.: 02 Si zt- - Lot#: Address: 5 5 2-9 c�=-,.•���, �� • • T Z Contractor: H797C-fe-1 s Owner: 13 0 h4-Aw �jNC' Date: z4Z3 % o Z_ (*APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION 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. Inspector: Date: PE OF INSIPECTION REQUESTED ❑ Under-floor ❑ Framing ❑ Gas Piping ❑ Footing ❑ Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in )L-)<Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: ftA INSPECTION REPORT 4�IN G To Permit No.: C Z 51 � L-ot #: Q' Address: Z-`1 Contractor: O Owner: 7441�I N O� Date: 12, ❑ APPROVAL /�X-PARTIAL APPROVAL ❑ VIOLATION ,XCORRECTION REQUESTED ❑ Corrections listed below MUST BE MADE before work can be approved. 0 Please contact inspector. ❑ Was not able to perform inspection. ❑ CALL 435-0674 FOR RE-INSPECTION - 4 hour notice required. ? ✓ems - .�'1�./I Inspector: s - Date: T E OF INSPECTI6 N REQUESTED ❑ Under-floor ❑ Framing ❑ Gas Piping ❑ Footing ❑ Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in ,Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: ¢titN G?'O Permit No.: n z Si z.Z Lot#: Q Address: 4 5 L 5 Contractor: +4y4-A4 4J 4-PQ J 0 O Owner: —)It:, jwt 9s4IN GG Date: 12 1 el zn' (W' APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION 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. T�S onr n� �ar����� �✓ate-���.� CAnwr a5 i x4 -ry 3 c (�A S CDD Inspector: S'4_,z,77_ Date: L2 1 Dz TYPE OF INSPECTION REQUESTED ❑ Under-floor ❑ Framing ❑ Gas Piping ❑ Footing ❑ Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in ❑ Final ❑ Masonry ;Drainage ❑ Insulation ❑ Other: INSPECTION REPORT ¢tiIN G TO Permit No.:�— j Lot #: Q' Address: Z Contractor: O Owner: 9s�IN Date: t1 _ ❑ APPROVAL ❑ PARTIAL APPROVAL VIOLATION ❑ CORRECTION 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. Q C�eG N x�, / •ttr/ Inspector: Dater PE OF INSP CTION REQUESTED ❑ Under-floor ❑ Framing ❑ Gas Piping ❑ Footing ❑ Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in ❑ Final LL ❑ Masonry ❑ Drainage ❑ Insulation f ❑ Other: fy I/p ��/ INSPECTION REPORT i�1b Yrl tiIN G rO Permit No.: 0�V ofC"e#: 4 Q Address: y Z Contractor: O Owner: 9s jNG( Date: IQ� 0)-�� APPROVAL ❑ PARTIAL APPROVAL © VIOLATION ❑ CORRECTION 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 otice required. Inspector: Date: PE OF INS CTION REQUESTED ❑ Under-floor ❑ Framing ❑ Gas Piping ❑ Footing ❑ Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: INSPECTION REPORT y1N G?'O Penrit No.: Z-2— Lot#: Address: 55 Zg CEM nD22�� KJ Contractor: 14797C-9-4 S 4-4n% O O Owner: Ry� IN G� Date: I / y—C) z� APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION 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. --inES -kszr��a AA A Inspector: ��s1 1 Date: TYPE OF INSPECTION REQUESTED ❑ Under-floor , ❑ Framing ❑ Gas Piping Rooting �'jL&v-kf ❑ Drywall, Nailing ❑ Consultation ❑ Foundation -77` ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: INSPECTION REPORT / ¢1.1N G TO Permit,No.: 5! � Lot#: Q' Address: 471 Contractor: q li�iiS LLt'!nd O Owner: ' .A �`r IN C'� Date: _ ❑ APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION CORRECTION REQUESTED Corrections listed below MUST BE MADE before work can be approved. ❑ Please contact inspector. ❑ Was not able to perform inspection. ALL 435-0674 FOR RE-INSPECTION -24 hour notice required. a ck � rt Inspector: �,'Z�� Date: TYPE OF INSPECTION REQUESTED ❑ Under-floor ) 4& ❑ Framing ❑ Gas Piping Footing ❑ Drywall, Nailing ❑ Consultation Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: INSPECTION REPORT ji T0Permit Flo.: ,/ Lot#: Address:Contractor: `k- G ,S0 Owner: 2�//j Date: APPROVAL ElPARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION 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. Inspector: Date: TYPE OF INAPECTION REQUESTED ❑ Under-floor ❑ Framing ❑ Gas Piping Footing ❑ Drywall, Nailing ElConsultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: i 1NSPE"10H REpe t 1J' 4 ?' Permit No.: t Lot#: Address:Contractor: OOwner:Date: ❑ APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION CORRECTION REQUESTED .0--sorrections 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. c` Inspector: Date: TYfE OF INSPECTION REQUESTED ❑ Under-floor ❑ Framing ❑ Gas Piping X❑ Footing Vim, ❑ Drywall, Nailing ❑ Consultation Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: C I TY QF ARL I IVGTQfV GQhISTRUCT I01V PERM I T PE Ft I T MC3_ a 02-5 1 22 Ovner: BOHN, LEISL 5529 CEMETERY ROAD ARLINGTON 98223 Value of Work: Tax ID: 310515-002-002-00 Phone: 206. 229. 2693 Describe Work: REPLACE EXISTING MOBILE WITH A NEW ONE Proposed Use: SFR/MOBILE Legal Description: Job Address: 5529 CEMETERY ROAD Contractor's Name Type Address License# HARRIS LAND DEVELOPMENT GEN 3711 CALLOW RD HARRILD012NR TOTALS Fee Permit Fee $500. 00 State fee $4. 50 (y-� SIGI�IAT�- TOTAL FEE. . . . . . . . . . . . . . . . . $564. 50 I HEREBY CERTIFY HAT I HAVE READ AND EXAMINED THIS APPLICATION AND PAYMENTS. . . . . . . . . . . . . . . . . . $0. 00 KNOW THE SAME TO BE TRUE AND COR- RECT ALL PROVISIONS OF LAWS AND TOTAL DUE. . . . . . . . . . . . . . . . . $504. 50 ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE/COMPLIED WITH WHETHER SPECIFI E R N OR NOT. DATE RECEIPT # 5� I IHG O F CIAL �\V �b . V x SC" _Jrl{xf I _161 1 MAIN CONSOLE; PERMITTR'AX CgWrhW2WGDyBUDDSoft argLLC Yef 1—2 a 34a9 1492C 31�1J 1 SEARCH PERMITS h Copyright 2006 by Bitco Softwrare,LLC `search permits: Address .", 5529 F— cemetm Emml 62-StU COMPLETE 113L -1 IT)11fM2 IMOBU ism iCEMETERY RO 894MM `COYN.ETL SLO.1 1Mf1"D - �YODLE 1IsmL - • • � � e-✓ 'l C4 t1 � G� - � U� LA/l� vt i ea (',orb• i St«t lobo,-WiosoftrLAook I '�J pam[ Ii se0.it% I1:33AM Friday,Sep 25,2009 11:33 AM Snohomish County, WA Assessor Parcel Data Page 1 of 2 Snohomishft-.. nment Information &Sorvicos County4* Washington R E A L * Property Information County Home Assessor Home Treasurer Home Information on which Department to contact Please view Disclaimer If you have questions,comments or suggestions,please Contact Us. Date/Time:9/25/2009 1:11:40 PM Answers to Frequently Asked Questions about Parcel Data(opens as new window) Return to Proper Information Entry page Parcel Number 31051500200200 Prev Parcel Reference 15310520020005 View Map of this parcel (opens as new window) General Information Taxpayer Name II Address (contact the Treasurer if you have questions) BOHN LIESL H 1111007 SE 322ND ST - - -AUBURN,WA 98092 If the above mailing address is incorrect and you want to make a change,see the information on Name and Address Changes Owner Name 11 Address (contact the Assessor if you have questions) BOHN LIESL H 1113710 45TH AVE S - - - TUKWILA, WA 98168 If the above name and address is incorrect due to a recent sale,please see the information on Name and Address Changes After a Sale Street(Situs)Address (contact the Assessor if you have questions) 5529 CEMETERY RD NE - - - ARLINGTON,WA 98223 Parcel Legal Description SEC 15 TWP 31 RGE 05 RT-11A-14A-1)THAT PTN FDP LY W14N SE1/4 NW1/4 BAAP ON N LN CO RD WH IS 165FT E OF W LN SE1/4 NW1/4 TH W ALG N LN SD CO RD 120 FT TH N PLT W LN SD SE1/4 NW1/4&NE1/4 NW1/4 TO CTR PORTAGE CR TH E ALG CTR SD CR TAP WH IS 165 FT E OF W LN SD NE1/4 NW1/4 TH S TO POB SUBJ ESE PUD Go to.toAof page Treasurer's Tax Information Taxes For answers to questions about Taxes, please contact the Treasurer's office (opens as new window) 2009 Taxes for this parcel $2,311.41 Payments:Receipt No. 4956160 4/23/2009 $1,155.70 (Taxes may include Surface Water Management and/or State Forest Fire Patrol fees and any fees related to late payments. LID charges,if any, are not included.) To obtain a duplicate tax statement,either download our Tax Statement Request form or call 425-388-3366 to request it by phone. Go to top of page Assessor's Property Data Characteristics and Value Data below are for 2009 tax year. Please contact the Treasurer's office for answers to questions about Taxes (opens as new window) For questions ONLY about property characteristics or property values (NOT taxes), please contact the Assessor's Office http://web5.co.snohomish.wa.us/propsys/Asr-Tr-Propinq/PrpIngO2-ParcelData.asp?PN=31... 9/25/2009 Snohomish County, WA Assessor Parcel Data Page 2 of 2 Property Values do not reflect adjustments made due to an exemption, such as a senior or disabled persons N"a 1 u es exemption. Reductions for exemptions are made on the property tax bill. Tax Year 2009 Market Land $156,1001 Market Improvement $112,2001 Market Total $268,300 Tax Year 2010 Market Land $145,000 Market Improvement $112,2001 Market Total $257,200 Go to tom ofpage Valuation, Payment, and Property Tax History View History(opens as new window) Go to top of page Property Characteristics Tax Code Area(TCA) 00110 View Taxing Districts for this Parcel(opens as new window) Use Code 118 Manufactured Home(Owned Site) Size Basis ACRE Size 0.65 (Size may include undivided interest in common tracts and road parcels) Go to top of page Property Structures Type Yr.Built Structure Description Mobile Home 2002 DoubleWide View Structure Data(opens as new window) Go to top of page Property Sales since 7/31/1999 Explanation of Sales Information (opens as new window) Sales data is based solely upon excise affidavits processed by the Assessor No sales for this parcel have been recorded since 7/31/1999 Go to top of page Property Maps Township/Range/Section/Quarter,links to maps Neighborhood 2408000 Explanation of Neighborhood Code(opens as new window) Township 31 Range 05 Section 15 Quarter NW Find parcel maps for this Township/Range/Section View Man of this parcel (opens as new window) http://web5.co.snohomish.wa.us/propsys/Asr-Tr-Propinq/Prp1ngO2-ParcelData.asp?PN=31... 9/25/2009 SNOHOMISH HEALTH L RICT FOR PDS USE r ''.Y �--t I� U r L.t J 'j-•ay--, 3020 Rucker Boa PDS PLAN ;CK# Everett WA 98201-3500 YJater/Wa^tewater Section 425.339.5250 SEC.63/GMA Compliance Required? YES ❑ NO❑ PDS NAME: REQUEST FOR A HEALTH DISTRICT CONSTRUCTION CLEARANCE AND/OR WATER.,SUPPLY COMMENT Property Tax Account Number 155105 -,�11 - oo ooC) c� Owners Name � Phone: Mail Address: City: 5'�z?� Contact Person: fl / - 1r J Zip:Phone:Mail Address: C- l City. SITE ADDRESS: CITY: l �— SITE LEGAL DESCRIPTION AND LOT#: SP#/Plat name Is Septic System/Drainfield: 9t4NSTALLED/EXISTING* E3 PROPOSED [,❑ NOT APPLICABLE *If installed/existing, approximate year of installation Has a new onsite sewage disposal system application been made to the Snohomish Health District in conjunction with this proposed building project? yes -4 no. Indicate source of water: ❑ INDIVIDUAL WATER SUPPLY UBL1C WATER SYSTEM Has an individual water supply application been made to the Snohomish Health District in conjunction with this building project? yes -4, no. Explain building project and its use (SFR, addition, shed, etc.): Is plumbing for any structures: ❑EXISTING ❑PROPOSED BOTH EXIS;ING/P�POS 1� Indicate total number of bedrooms before and after construction: / ATTACH A COPY OF PLOT PLAN-8 1/2"x 11"minimum showing: /ys4o� <900 U 1. Dimensions of Property Lines. 4. Location of Septic Tank and Drainfield,if known. 2. Dimensions of Existing Structures and 5. Roads, Easements, Driveways, Parking and I'avemen� their distances from Lot Lines. 6. Location of Water Well. r�Cj 3. Dimensions&Description of Proposed Construction. 7. North Arrow. NOTICE: A Re We Upon Issuance of the Buildingp PerM SIGNATURE OF APPLICANT. vi Fee ay Paya DATE: 1 11r FOR HEALTH DISTRICT USE ONLY �.�■ WATER SUPPLY INFORMATION: (If Required By Building Department) ❑Appears to be consistent with recommendations contained in"Guidelines for Determining Water Availat ility for New Buildings", issued April, 1993 as per Section 63 of Growth Management Act(GMA). ❑ Does not appear to be consistent with recommendations contained in "Guidelines for Determining Watea Availability for New Buildings", issued April, 1993 as per Section 63 Growth Management Act (see attached sheet fOr deficiencies). ONSITE SEWAGE DISPOSAL SYSTEM: ❑ 5100 Field Review F-1 S55 Office.Review APPROVED: ❑ CONDITIONAL APPROVAL: ❑ DISAPPROVED: REVIEWING SANITARIAN: DATE: BUILDING CLEARANCE APPROVED., BASED UPON REVIEW OF THE ONSITE SEWAGE DISPOSAL SYSTEM INFORMATION AND,WHEN APPLICABLE, E/W /JE SU7� NFORMATION.G SANITARIAN: DATREVIEWIN — //f1 h E � J ' `-V� ,van rev030702j meJuau[dojaeaQ pus? sz.zasg E9ZOL6E5Zk XF3 R9:0T HILL Z0/0T/Z' �r ('re5 Two #- �tj. } j � f e-�-VC ! -jwd as 4;a 5p i*,A e6e-k, vt mtis 01PU )t T 43 — PChnoV L(o' f i d Wn � i •Y fi r £OO[p] luamdOj@AOa pus? ST.zasg £9ZOL6£SZV YVA 99:OT aaj, ZO/01/ZT • / �el L C(M C r� l:v_ u6 S�o c-k P e covereA �i, 'l�'S�ur�►�� d-y Sees �1'Y e r v i ov-S ao-(� CIO, rav Afl, Lea I as be- Of �Wnk (e w\a•v 1 Prt ®F � ' u,L. t APp ED wp a DA AU7H0 EBy D ! q �'ES VED THE {1-! Wj X APp IN —f BUILDING IN r RECEIVED 'ID-0 JUL 1 0 2002 . 5 SV�j`e`G CITYCIFARLINIGT aK 1 SNOHOIVrI�SH HEALTH DIS- CT Environmental Health Division Courthouse, Everett, WA 98201 153105-2-002-0005 339-5270 (Property Tax Account Number) APPLICA7N FOR AN ONSITE SEWAGE DISPOSAL PERMITX)M New ❑Renewal ❑Redesign ❑Repair [IAlteration ❑Alternative Applicant K_fIz Bohn Phone 652-7967 Mailing addressl�1. [—Lakewood Road,N-N. ,r� (1215-Lk.wood) t Arlington Zip 98223 For installation at .20—Cemetery Road City Arlington 98223 Sec. 1 Twp. ,a 1 Rg. 5 Legal description A i ir, V y B y r�,Fg+ v on 04 C o•r t r Short Plat/LLS No. Lot Plat th IJ PLT �' oft,N SD sir<E4 . Type of Building:1,New X Existing SFR_� Duplex_�--�t, t1; No. Bdrms. 3_ Commercial_. Other Water Supply: Public ;(X Name _Ar1inp,ton dater System (Attach Letter of Availability) Private Source protective Covenants Attach a detailed drawing to scale of the onsite system indicating: soil log holes, drainfield lines, 100% reserve area, contours, elevations, bodies of water, property lines, house location, banks, excavations, easements, north, and any proposed or existing well within 100 feet. SOIL LOG 1. 0-50" Litt- Brown Sa.ndly-Gravelly-Loam & 2"-94" Rocks . 7ari a� SOIL LOG 2. ! a 1 • 1 1.1 i/`li+ � ; ' , r1r� C I_l; l 7.) SOIL LOG 3. 7,a,,t- as # 1 • SOIL LOG 4. # 1 • TiFjf 1 SOIL LOG 5. AS # 1 • SCS CLASSIFICATION #17—Everett gravelly SOIL TYPE II APPLICATION RATE 1 .2 y �aalJsq. ft./day DEPTH TO HIGHEST SEASONAL GROUNDWATER inches OBSERVED ESTIMATED DATE_ SEPTIC TANK SIZE1 "()O(2—COr��lbns TRENCH: SO. FT. 376Sq• Ft•WIDTH 24" inches DEPTH ,�0r� inches REQUIRED COVER SOIL: DEPTH non, inches,and VOLUME cubic yards i4 ACT,ION DRA/I�NFIELD DESIGNS Signature of Designer /b4f f�L�_=% License No. 2b3_ 51 Phone No. 659-041 5 Address 1036 Beach Ave , City `?ar.ysville Zip 98270 Date July 22 ,199 DO NOT WRITE BELOW THIS LINE Application Denied Date ! / Sanitarian Pending: (Date) APPLICATION APPROVED_ Date g / Z / / SANITARIAN PERMIT ISSUANCE APPROVED Date_ I / SANITARIAII PERMIT ISSUED: (Date) / ! BY PERMIT NO. Called For Inspection: (Date) I i By Installer Renewal By Date / / Final Inspection—BY—Date / ! ' See reverse side for additional information MEMO13t-,�/ December 30, 1987 TO: Onsite Sewage Disposal System Permit Applicant FROM: Environmental Health Division, Sanitation SUBJECT: Approved Onsite Sewage Disposal Application SNOHOMISH HEALTH The following information concerns your approved onsite sewage disposal system DISTRICT application and design. If you have any questions,feel free to call us at 339-5270. M.WARD HINDS,M.D.,M.P.H - Snohomish Health District application approval is valid for two years from the date Health Officer of approval. - An application approval is not a permit i for installation of the onsite sewage DISTRICT MEMBERS disposal system. COUNTY Snohomish - A sewage disposal system installation permit will be issued at such time as a CITIES AND TOWNS construction permit for this proposed structure is issued from the city/county Arlington building department. Please allow a 5-10 day minimum processing time for Brier Darrriington permit issuance. The permit will generally be transmitted to you with your building Edmonds permit. Everett p Gold Bar Granite Falls Index - Upon expiration an approved ap a- Lake Stevens !on may be renewed for two additional years Lynnwood with written concurrence from the system designer or engineer and the Health Marysville Mill Creek District and payment of a renewal fee. (Renewal must be received within 30 days Monroe Mountlake Terrace from the date of expiration). Mukilteo Snohomish Stanwood Sultan A Snohomish Health District installation permit will remain valid concurrent with " Woodway the city/county building permit (maximum 18 months). - Renewal of an expired onsite sewage disposal installation permit will require SNOHOMISH HEALTH DISTRICT renewal of the application approval and repayment of review fees. Courthouse Everett,WA 98201 GENERALINFerett ON 339-5zoo - Onsite sewage disposal systerns shall be installed by installers certified by the Snohomish Heath District. A current list of certified installers is available upon ADMINISTRATION 339-5210 request. MAIN CLINIC 339-5220 TUBERCULOSIS CLINIC 339-5225 - A request for the inspection of an onsite sewage disposal system installation PUBLIC HEALTH NURSING 339-5230 must be made to the system designer or engineer who will, upon inspection and CRIPPLED CHILDREN'S SERVICES 339-5240 approval of the installation, request final inspection and approval from the Health ENVIRONMENTAL HEALTH 339-5250 District. FOOD PROGRAM 339-5260 SANITATION PROGRAM 339-5270 - The timely inspection of the system installation and preparation of the as-built VITALSTATISTICS 339-5280 drawing is the obligation of the system designer. SOUTH COUNTY CLINIC 775-3522 EAST COUNTY CLINIC 793-0201 - As a precaution, the soil in the designated drainfield and reserve areas should AIDSPROGRAM 259-2330 remain Undisturbed. - Application approvals are contingent upon placement of the proposed structure as shown on the approved (attached) onsite sewage disposal system plot plan and design. Contact your designer if changes or revisions are contemplated. All revisions are subject to review and approval by the Snohomish Health District. A copy of the Health District's appear process will be furnished upon request. RSD:ks CITY OF ARLINGTON CONSTRUCTION OFFICE COPY PERMIT �a.•�J� ❑ COMBINATION BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO. INNER Ir- MAIL ADDRESS CITY ZIP PHONE del, �� a� c�vr � d �-r�vn i,� Z z 3 -e►�-Z z9•zG 1 ,RCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE ANERAL CONTRACTOR MAIL ADDqRESS CITY ZIP PHONE LIC NSE 0 5 �1/ 1> X tt iZRi��©�aN MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE IT PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE IF CLASS OF WORK A W ❑AUDITION ❑ALTERATION ❑REPAIR ❑DEMULI LION ❑BUILDING RELOCATION VALUATION OF WORK S DESCRIBE WORK / t ! ; ` L 't PRUPOSI LJ USE C11 BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- LLUAL DESCRIPT ION OF PROPERTY(SHOWN BELOW OR ATTACH FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK LUI BLOCK OF WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO 0 b q --Z) d . O VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR TAX I D NUMBER LOCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF r CONST ON.PERMIT EX IRES 1 YEAR FROM DATE OF ISSUANCE. (,' 1_ SIGNATU NT R OR AU HO ZED AGEM'l DATE 108 AUURLSS (OFFICE USE ONLY) MECHANICAL G ll lJ PLUMBING NO. TYPE Of FIXTURE FEE NO. TYPE OF EQUIPMENT FEE WATER CLOSET (TOILEI) _AIR COND.UNITS -H.P. EA BAI F11 UB REFRIGERATION UNITS-H.P EA. LAVATORY (WASH BASIN) BOILERS- H.P.EA SHOWLR GAS FIRED A.C- UNITS - TONNAGE EA FORCED AIR SYSTEMS- 8 T.0 MEA KI ICIILN SINK& DISP. WALL HEATERS- B.T.0 M UISHWASIILR LAUNDRY I RAY UNI1 HEATERS- B.T.U. M CLUI ILLS WASIFER EVAPOKAI IVE COOLERS WAIERHEA7LR CLUTHESUR.YERS VENTILATICN FAN URINAL OD COMMERCIAL DRINKING FUUN I AIN RANGE FIO AIR HANDLING UNIT- CPM FLUOR DRAIN STOVE VACUUM BREAKERS METAL FIREPLACE &CHIMNEY ROOF DRAINS - RAINLEADERS SINK (SERVICE - BAR,E FC.) WATER HEATER GAS PIPING SUBTOTAL s SUBTOTAL s s PERMIT f PERMIT TOTAL FEE f TOTAL FEE s PLAN CHECK FEE SIDE YARD by I BACK STREESTBACK REAR ZRD SETBACK PLAN CHECK NUMBER FEE RECEIPT NO. 1 5t f)Nf (! LOT AREA �OANT SITE FEES VALUATION FEE YES �NO PLAN CHECKING NG OCCUP NCY GROUP F WELLING UNITS BU'LDING SIZE Of BLDG. NO.OF ST RILS MAX.?LOAD 7 I/ PLUMBING �— FIRE SPRINKLERSREQUIREU ❑YES NO MECHANICAL _ f ' I STATE BLDG.CODE "► C/ COMMENTS ENERGY CODE SURCHARGE U.B.G. ��--++ R E G e I r/ PENALTY SEC.303(a) 5-1) WATERISEWER FEES TOTAL J U L 10 Z0 JC ' PERMIT VALIDATION WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS 15 YOUR PERMIT&RECEIPT CITY OF ARLINGTON BY PAID CR#_� O DATE BUILDING OFFICIAL cc: ASSESSOR,APPLICANT,TREASURER,el oG. DEFT. RECORDS COPY CITY OF ARLINGTON CONSTRUCTION PERMIT QQ ❑ COMBINATION ® BUILDING ❑ MECHANICAL ❑ PLUMBING El SIGN PERMIT NO.00088 OWNER MAIL ADDRESS CITY ZIP PHONE Ken Bohn 1215 Lakewood Rd , NW Arlington , WA 98223 652-7967 ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N owner MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE# CLASS OF WORK ®NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑BUILDING RELOCATION VALUATION OF WORK 5 DESCRIBE WORK Set up mobile home instal septic system PROPOSE D USE OF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- LLGAL DES RIPTION OF PROPERTY(SHOWN BELOW OR ATTACH FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK LOT-BLOCK-OF WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO _ VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR TAX ID NUMBER LOCAL LAW REGULATING CONSTRUCTION OFTHE PERFORMANCE OF CONSTRUCTION. PERMIT EXPIRES I YEAR FROM DATE OF ISSUANCE. SIGNATURE OF CONTRACLOR OR AV HO ZED AGENT DATE jOBADDRLSS Cem i tar t Road Arlington, WA X L-`. � . �2 "' (OFFICE USE ONLY) MECHANICAL PLUMBING NO TYPE OF FIXTURE FEE NO. TYPE OF EQUIPMENT FEE WATER CLOSET (TOILET) AIR COND.UNITS -HY.EA. BA I HT UB REFRIGERATION UNITS-H.P.EA LAVATORY (WASH BASIN) BOILERS-H.P. EA SHOW'LR GAS FIRED A.C.UNITS-TONNAGE EA KI ICHLN SINK& DISP. FORCED AIR SYSTEMS- B.T.0 MEA DISHWASHER WALL HEATERS- B.T.U. M LAUNDRY T RAY UNIT HEATERS- B-T.U. M CLOTHES WASHER EVAPORAI IVE COOLERS WATERHEATLR 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 SUBTOTAL f PERMIT $ PERMIT $ TOTAL FEE $ TOTAL FEE $ SIDE YARD SE IBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE FEE RECEIPT NO. USE ZONE LOT AREA VACANT SITE ❑ FEES VALUATION FEE ❑YES NO TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS PLAN CHECKING NG SIZE OF BLDG. NO.OF STORIES MAX.00C.LOAD BUILDING $ PLUMBING FIRE SPRINKLERS REQUIRED ❑YES ❑NO MECHANICAL COMMENTS STATE BLDG.CODE 4 50 ENERGY CODE SURCHARGE PENALTY U.B.C. SEC.303(a) Permit t`� ued fQr i;ndtal l dtl of Mobile h_o m e only,, WATER/SEWER FEES NO1DNI'W jo TOTAL 89.4 50 PERMIT VALIDATION iUsgsWHEN iE Q (INTHISSP ) THIS URPERMIF& CFJPT ` d9s � `PAID CR# Y r rG cc:ASSESSOR,APPLICANT,TREASURER, BLDG. DEPT. /U" 1 OFFt".4 DATE RECORDS COPY . ... ... � w-. ....�.a .�..-...... w.r..« •.+...reeve a.w.c::as .-.as, .___. .,-,.,s �,.,,.,...._ ".-, C1IY OF ARLING-I UN CONSTRUCTION AUG -' PERMIT. 9- '1 U COMBINATION BUTLOIN0 ❑ MECHANICAL ❑ PLUMBING ❑ 51 D�� U'AN MAlt-ADDRESS ) CITY 21► ►tIUtJE - ARCIIIItClORUESIGNER ^ MAIL AUVRESS CITY 211 f11VNE (,!Nl RAL CVNIRA-I TU� Mi11L AUURE55 CITY 21I IINNiE LItT r+SEf MlCIIAt�TICAI(LON R CIOR MAILAUURESS CITY TIP r1I(RJE LICENSE/ fIUMBINGCONIRAUOR MAIL ADDRESS CITY 2R PIIONE LICLNSlI (LASS Of WORK %N UAIIOIIION ❑ALIERAIION ❑REPAIR ❑DEMOLIIION ❑BUIIDINGRELOCATION VALUAIIONUF WORK e UlSLRIB'F WORK /RUPUSI U USE UI TIUtI UIN(i I FIEREBY CERTIFY THAT I 1 IAVE READ AND EXAMINFD 11115 APPLICA- I ION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- 1i(A_ utsl Il1VTWNuirRurLrtIY(SHOWN BLLOWOR AITACIT f OUR COMES). SIONS OF LAWS AND ORDINANCES GOVERNING 11115 TYPE OF WORK lUl BLtxK or WILL BE COMPLIED WITH WHET IER SPECIFIED HERIN OR NOT.I IE GRANTING OF A FERMI T DOES NOT PRESUME 10 GIVE AU11 IORI1 Y 10 (Xj VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER SIAIE OR TAX ID NuMeER LOCAL LAW REGULATING CONSIRUCT ION OF 11 IE PERFORMANCE OF CONS1 RUCTION.PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE. ' RUC�r SIGNAIUREOfCONTRACIOR Olt Alit tIOI(1ZEDAGENT DATE Joe %vURLSS' 1 kv IOF F ICE USE'ONLY) MECIIANICAL PLUKIRING NO _ 1YPEOF FIXIURE FEE NO. TYPE or EOUIrNIENI TEE _ ISAILRCLUSLI (IVILLI) _AIRCU_N_U.UNIIS -II.P.EA. _ BA I II 1 11B REF RIGERA I IUN UNI I S -II.P.LA, _ LAVAIURY IWASII BASIN) BOILERS-II.P.EA __ 511ORlR GAS FIRED A.C.UNIIS- IUNNAGE EA. I = KI ICIILN 5114K d OISP, FORCED AIR SYSTENIS- B.T.U. MEA UISIIWASIILR_ WALL IIEATERS- B.T.U. AI _ LAUNURYIRAY UNIIIIEAIERS- B.I.U. M _ CLOHILS IVASIILR EVAPURAII'/E C_UOLERS _ 'AAI_LR IILAILR CLUIIIESUR.YERS _ URINAL VLNI ILA IION FAN _ DRINKING 1 UUN I AIN _RANGE IIUU_U COMMERCIAL _ I LU_U_R DRAIN_ AIR IIANDLING UNI I - CI'M _VACU_U_M_BR_LAKERS _ SIOVE RUUI DRAINS - RAINLEADERS NIETAL FIREPLACE d CHIMNEY _ SINK ISERVICE - BAR•EIC.) WATER IIEATER _ GAS PIPING SUBTOTAL * 1 SUBTOTAL f PERMIT_ PERMIT 1 _ IOIAL FEE 1 TOTAL TEE 11- SIUL r ARU SL I BACK S I RLL I SL I BALK REAR YARD SE I BACK rLAN CIIECK NUMBER rLAN UIF(K I IE IEE RECEIr1 NO. ------- ------ -------- USk /UNI LUI AREA VACANI SIIE _-- []YES no 1 EES VALUAI ION ILL I rf!UI CVNS1, VCCIIrANC�GRVVr, NO.VF UWELLIN--:;UNIIS PLAN Cl IECIONG `IG RUILDING S SILL UI BLDU. 40.01 SIORILS MAX.UCC.LOD PLUNIBING I IRE SPRINKLERS REQUIRED U YES u ND MECI IANICAL COMMEN f S s1niE BLUG.CODE ENERGY CODE SURCI IARGE _ PENALIY SEC..3 JOJI11 WAl ER/SEWER FEES TOTAL PERhIII VAUDAIION WITEN rROrERLY VALIDATED BN Tills SrACEI 1111S IS YOUR PtPj ul 6 RECEIPT PAID CRII BY cc:ASSESSOR.APPLICANT.TREASURER,SLOG.DEPT. eUnDIIUi(lrrlclll DAII IIECORDS COPY