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Home My WebLink About223 W Lebanon ST_BLD00081_2025 ZN OTICE:t Inspection Report A c Address LLDII �� 7— Contractor Owner Requested by TYPE OF INSPECTION REQUESTED ❑ 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 _>4J(IOLATION ❑ 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. c. 72 Inspector Date I was present during this inspection. CITY OF ARLINGTON, WASffi,. TON BUILDING DEPARTMENT SIGN PERMIT APPLICATION DATE b OWNER & ADDRESS ZC.C- <,- ,,.('—GT✓z r H C1 �,24-L 4 . ERECTOR & ADDRESS S�a,;,� DESCRIPTION OF PROPERTY: Street: & No: Z 3 3 W C c.b4L0. L ST �i:4 Lot No. Block No.' Subdivision or unplatted d cription USE ZONE FIRE ZONE ' ' ' PLAN CHECKING FEES PERMIT FEE APPLICATION IS HEREBY MADE FOR PERMISSION TO ( ) ERECT OQ .ALTER ( ) MOVE ( ) REPAIR A ( ) PROJE TING ( ) TEMPORARY ( ) GROUND ( ) ROOF ( ) WALL (X) OTHER, DESCRIBED AS FOLLOWS: - !1 wv+ L . SIGN of a type similar to that checked and described below, fastened and secured by approved supports, and it is hereby agreed that if this application is approved the sign will conform in every detail with the requirements of the Building Code, Sign Code, Zoning Ordinance and all City Ordinances and State Law. SIGN WILL BE ( ) illuminated non-illuminated ( ) plain wood (, ) plain metal ( ) neon ( ) electric. SIGN WILL WEIGH Cl' pounds . Length width Type of wall to which sign will be secured: ( )Masonry ( ) Frame. Will sign obstruct a fire escape, window or door? ( ) yes (>e) no If yes, Explain Lower edge will be ft inches above grade. Face area sq.ft. Inner edge will be inches from the building. Outer edge will be inches from the building. Lower edge will be feet above the alley, sidewalk or private property grade. Sign will project inches beyond the street line. Sign will extend feet inches boveithe building. Of what material will the sign be constructed? Face ;;. Frame j Support 1 Wording of Sign I�t5 The undersigned certifies that the above statements are true to the best of his knowledge and belief. Applicant APPROVAL OF BUILDING INSPECTOR SHALL. E REQUIRED BEFORE ERECTION. Approved for issuance of Permit Building Inspector DATE WORK COMPLETED AND APPROVED ' DATE I P A I D JUN W 1989 CITY OF ARLINGTON CITY OF ARLINGTON CONSTRUCTION PERMIT Qp ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ElPLUMBING ElSIGN PERMIT NO.0008 OWNER MAIL ADDRESS CITY ZIP PHONE Jerome St. Martin 5206 S . 2nd Everett , WA 98208 ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N CLASS OF WORK ❑NL W n ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑BUILDING RELOCATION VALUAl ION OF WORK f 100 DESCRIBE WORK Paint new sign on existing sign surface, PROPOSE U USE OF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- S i g n Only TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- ��LLGAL TAM RIPTION Of PROPERTY(SHOWN BELOW OR ATTACH FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK �\ LOI BLOCK OF WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITYTO 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. SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE JOB AUDRI SS 223 W Lebanon St , X (OFFICE USE ONLY) PLUMBING MECHANICAL NO. TYPE OF FIXTURE FEE NO. TYPE OF EQUIPMENT FEE WATER CLOSET (TOILEI) AIR COND.UNITS -H P. EA. BA I FI I UB REFRIGERATION UNITS-FI.P.EA. LAVATORY (WASH BASIN) BOILERS-H.P.EA SHOWLR I GAS FIRED A.C.UNITS-TONNAGE EA. KI ICIILN SINK&DISP. FORCED AIR SYSTEMS- B.T.U. MEA DISIIWASIILR WALL HEATERS-B.T.0 M LAUNDRY 1 RAY UNIT HEATERS- B T.0 M CLOT I ILS WASHER EVAPORAT IVE COOLERS W'AI ER HEATLR CLOTHES DRYERS URINAL VENTILATICN FAN DRINKING FOUN I AIN RANGE HOOD COMMERCIAL I LOOR DRAIN AIR HANDLING UNIT- CPM VACUUM BRLAKERS STOVE ROOF DRAINS - RAINLEADERS METAL FIREPLACE&CHIMNEY SINK (SERVICE - BAR,ETC.) WATER HEATER GAS PIPING SUB TOTAL $1 1 SUB TOTAL f PERMIT ; PERMIT t TOTAL FEE f TOTAL FEE $ _ SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE FEE RECEIPT NO. USE/ONE LOT AREA VACANT SITE ❑YES ❑NO FEES VALUATION FEE TYPE OF CONST, OCCUPANCY GROUP NO.OF DWELLING UNITS PLAN CHECKING VG SIZE Of BLDG. NO.OF STORIES MAX.OCC.LOAD B(/ILU49 X S i g n $ 10 00 PLUMBING FIRE SPRINKLERS REQUIRED ❑YES ❑NO MECHANICAL COMMENTS STATE BLDG.CODE 3 50 ENERGY CODE SURCHARGE PENALTY U.B C. SEC.303(a) SIGN ONLY WATER/SEWER FEES TOTAL 13 50 PERMIT VALIDATION WHEN PROPERLY VALIDATED TIN THIS SPACE)THIS IS YOUR PERMIT&RECEIPT PAID CR# BY 4w, 'dip cc:ASSESSOR,APPLICANT,TREASURER, BLDG. DEPT. ZILDNIGOFFICIAL ATE RECORDS COPY CITY OF ARLINGTON CONSTRUCTION PERMIT :HANICAL ❑ PLUMBING ❑ SIGN PERMIT NO.0008 CITY ZIP PHONE nd Everett , WA 98208 .- JJ { CITY ZIP PHONE CITY ZIP PHONE LICENSE# . 111 CITY ZIP PHONE LICENSE ' CITY ZIP PHONE LICENSE# CLASS OF WORK ❑AN4T ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑BUILDING RELOCATION VALUATION OF ; 100 DESCRIBE WORK Paint new sign on existing sign surface , PROPOSED USE OF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- S i gn Only TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- ,� LEGAL DESCRIPTION Of PROPLRTY(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 OFA PERMIT DOES NOT PRESUME TO GIVE AUTHORITYTO ►►► 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 CONTRACTOR OR AUTHORIZED AGENT DATE • 108 ADDRtSS 223 W Lebanon St . X (OFFICE USE ONLY) MECHA PLUMBING NO. TYPE OF FIXTURE FEE 40. TYPE O QUIPMENT FEE WATER CLOSET (TOILET) AIR COND.UNITS -H - EA- BAIEIIUB REFRIGERATION UNIT -H P EA. LAVATORY (WASH BASIN) OILERS-H,P.EA SHOWER Gk FIRED A.C.UNIT -TONNAGE EA. KI TCHLN SINK & DISP. FOR ED AIR SYST S- B.T.0 MEA DISHWASHER WALL EATERS B T U M LAUNDRY TRAY UNIT HE TE - B.T.U. M CLOIHESWASHER EVAPORA JECOOLERS WAIER HEATER CLOT DRYERS URINAL V TILATICN FAN DRINKING FOUN I AIN RANGE HOOD COMMERCIAL FLOOR DRAIN / AIR HANDLING UNIT- CPM VACUUM BREAKERS STOVE ROOF DRAINS - RAINLEAU S METAL FIREPLACE &CHIMNEY SINK (SERVICE - BAR,ETC) WATER HEATER GAS PIPING SUBTOTAL $1 SUBTOTAL $ PERMIT ; PERMIT $ TOTALFEE $1 TOTALFEE ; SIDL YARD SE IBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE FEE RECEIPT NO. USE/ONI LOT AREA VACANT SITE ❑YES ❑NO FEES VALUATION FEE TYPE OF CONST OCCUPANCY GROUP NO.OF DWELLING UNITS PLAN CHECKING VG SIZE OF BLDG NO.OF STORIES MAX.00C.LOAD B(X XXX X S i g n ; 10 00 PLUMBING FIRE SPRINKLERS REQUIRED ❑YES ❑NO MECHANICAL COMMENTS STATE BLDG.CODE 3 50 ENERGY CODE SURCHARGE PENALTY U.B.C. � O0 SEC.303(a) S TG N ONLY WATER/SEWER FEES TOTAL -0 PERMIT VALIDATION /I� WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT&RECEIPT 7 6 PAID CR# BY 1 -4% —,IgfV cc:ASSESSOR,APPLICANT,TREASURER, BLDG. DEPT BUILD GOFFIR DATE RECORDS COPY CITY OF ARLINGTON CONSTRUCTION PERMIT ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO. OWNER - .MALL ADDRESS CITY ZIP PHONE .1.0 ZJL . llar i m - - ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE# PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N CLASS OE WORK `1 ❑NE W' ❑ADDITION ❑ALTERATION ❑ REPAIR ❑DEMOLITION ❑BUILDING RELOCATION VALUAi10N OF WORK S DESCRIBE WORK Faint new Sion on existing sign surface . PROPOSE D USL OF BUILDING i g n �n� '.� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- LLGAL Dt Sc RIP)ION o1 PROPE RTY tSHOWN BT LCTw OR ATTACH H FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK LOI BLU(K 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 1 YEAR FROM DATE OF ISSUANCE. SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE icesA R3 1? I obanon St . X (OFFICE USE ONLY) MECHANIC'AE"_"` `- PLUMBING NO TYPE OF FIXTURE FEE NO TYPE OF EQUIPMENT FEE WATLR CLOSET (TOILLT) AIR COND UNITS - H P. EA BAIH1UB REFRIGERATION UNITS - H P EA LAVATORY (WASH BASIN) BOILERS H P EA SHOWLR GAS FIRED A C UNITS -TONNAGE EA KI ICHLN SINK & DISP FORCED AIR SYSTEMS - B T U MEA DISHWASHLR WALL HEATERS,L B T U M LAUNDRY T RAY UNI I HEATERS- B T U M CLOTHLSWASHLR EVAPORAIIVECOOLERS WAILRHEATLR CLOTHESDRYERS URINAL VENTILATION FAN DRINKING, I OLIN I AIN RANGE FIOOD COMMERCIAL I LOOR DRAIN AIR HANDLING UNIT - CPM VACUUM BRLAKERS STOVE ROOF DRAINS RAINLEADERS METAL FIREPLACE &CHIMNEY SINK (SERVICL - BAR, ETC ) WATER HEATER GAS PIPING SUB TOTAL f SUB TOTAL S PERMIT S PERMIT S TOTAL FEE S TOTALFEE f SIDE Y ARD SE I BACK STRLL I SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE FEE RECEIPT NO LOT AREA VACANT SITE ❑YES ❑NO FEES VALUATION FEE TYPE OF CONS OCCUPANCY GROUP NO OFDWELLING UNITS PLAN CHECKING NG BUILDING f SIZE 01 BLDG NO OF STORIES MAX OCC.LOAD PLUMBING FIRE SPRINKLERS REQUIRED ❑YES ❑NO MECHANICAL COMMENTS STATE BLDG.CODE ENERGY CODE SURCHARGE PENALTY U B C = SEC 303(a) _ WATER/SEWER FEES TOTAL PERMIT VALIDATION WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT&RECEIPT ~�? PAID CR# BY cc:ASSESSOR,APPLICANT, TREASURER, BLDG DEPT BUILDING OFFICIAL DATE TREASURER'S COPY CITY OF ARLINGTON CONSTRUCTION PERMIT ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGNti� PERMIT NO.u OYNtR w ,{ ,4AL DDR�SS CITY P rZ,�P PHONE ARCHITECTOR DESIGNER MAIL ADDRESS CITY ZIP PHONE GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LIC NSE 8 MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE# PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE# CLASS OF WORK 1 ❑NE'A ADDITION ❑ALTERATION ❑ REPAIR ❑DEMOLITION []BUILDING RELOCATION VALUATION OF WORK 4 i $ DESCRIBE WORK PRUPOSI U USE OF BUILDING .; ID � 7 �� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- S ' LLGAL 004 RIPTION 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 PRESUMETO GIVE AUTHORITYTO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR TAX ID NUMBER LOCALLAW REGULATING CONSTRUCTION OF THE PERFORMANCEOF CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE. _ ��,u�,Rf SS SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE - L � �I vtt r t , X (OFFICE USE ONLY) M E C H Af+f�C A PLUMBING NO, TYPE OF FIXTURE FEE NO TYPE ONQUIPMENT FEE WATLRCLOSET (TOILLI) Q AIR COND UNITS - HP EA. BAIHIUB REFRIGERATION UNITS - H P EA. LAVATORY (WASH BASIN) BOILERS - H P EA SHOW LR \ GMj FIRED A.C. UNITS -TONNAGE EA KI IC[]LN SINK& UISP FOR> D AIR SYST S - B T U MEA DISHWASHER WALL HEATERS_,- B T U M LAUNDRY T RAY UNIT HERTEIRS- BTU M CLOIHLSWASHER EVAPORATM.COOLERS WATER []LATER CLOTI.. SDRYERS URINAL VENTILATION FAN DRINKING F OUN 1 AIN RANGE HOOD COMMERCIAL I LOOR DRAIN AIR HANDLING UNIT- CPM VACUUM BREAKERS STOVE ROOF DRAINS RAINLLADERS METAL FIREPLACE &CHIMNEY SINK (SERVICE - BAR, ETC) WATER HEATER GAS PIPING SUB TOTAL $ SUB TOTAL $ PERMIT $ PERMIT $ TOTAL FEE $ TOTAL FEE $ SIDE.1 ARU SL I BACK STRLLI SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE FEE RECEIPT NO US['/ONE LOT AREA VACANT SITE ❑YES ❑NO FEES VALUATION FEE TYPE OF CONSI OCCUPANCY GROUP NO.OF DWELLING UNITS PLAN CHECKING NG B��1'ti '( C.1 n " " SIZE OF BLDG. NO.OF STORIES MAX-OCC LOAD UYL`DING $ PLUMBING FIRE SPRINKLERS REQUIRED ❑YES ❑NO MECHANICAL COMMENTS STATE BLDG.CODE ENERGY CODE SURCHARGE PENALTY UBCSEC 303(a) af_ I A L� WATER/SEWER FEES TOTAL PERMIT VALIDATION v '1 WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT&RECEIPT PAID CR# BY cc: ASSESSOR,APPLICANT, TREASURER, BLDG DEPT BUILDING OFFICIAL DATE TREASURER'S COPY CITY OF ARLINGTON CONSTRUCTION PERMIT �] O►U❑ COMBINATION ❑ BUILDING � ❑ MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO.L�0081 YON ome St. Martin �tIJ�DDR�S Znu CI�� ' � PHONE Ever , I n, ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LIC NSE M MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE A PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE 0 f CLASS OF WORK ❑NEW' ADDITION ❑ALTERATION ❑ REPAIR ❑DEMOLITION (]BUILDING RELOCATION ` VALUATION OF WORK 100 S DESCRIBE WORK Paint new sign an existing sign sjrface . r PROPOSE D USE OF BUILDING ' �i�;n Only I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- �., TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- ILGAL UES('RIP110NUF PROPERTY(SHOWN BELOW OR ATTACH FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK .,� WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE LUI BLOCk OF GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OFTHE PERFORMANCE OF TAX ID NUMBER CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE. SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE IOB,1k) R>SS J Lebanon St . X (OFF/ICE USE ONLY) MECH�NIC'A'C'— PLUMBING --`'— NO. TYPE OF FIXTURE FEE NO. TYPE OF EQUIPMENT FEE WATER CLOSET (TOILET) �t AIR COND. UNITS - H P. EA. BATHTUB REFRIGERATION UNIT - H.P.EA. LAVATORY (WASH BASIN) 8QILERS- H.P EA SHOWER GA$FIRED A.C. UNI -TONNAGE EA. KI ICHLN SINK& DISP FORCED AIR SYSTEMS- B.T U MEA DISHWASHER WALL HEATERS.= B.T U M LAUNDRY T RAY UNI1 HEATERS`- B.T.U- M CLOIHES WASHLR EVAPORA.11VE COOLERS WAIER HLATLR 1 CLOTHESDRYERS URINAL VENTILATION FAN DRINKINU FOUNIAIN RANGE HOOD COMMERCIAL FLOOR DRAIN AIR HANDLING UNIT- CPM VACUUM BREAKERS STOVE ROOF DRAINS RAINLEADL RS METAL FIREPLACE &CHIMNEY SINK (SERVICE - BAR,ETC ) WATER HEATER GAS PIPING SUB TOTAL ; SUBTOTAL f PERMIT ; PERMIT ; TOTAL FEE ; TOTAL FEE f SIDL YARD SE I BACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE FEE RECEIPT NO. USE LONE LOT AREA VACANT SITE ❑YES ❑NO FEES VALUATION FEE TYPL OF CONS OCCUPANCY GROUP NO OF DWELLING UNITS PLAN CHECKING NG BtxJILDIFIG�r S i<�fl f -'-' - SIZE OF BLDG NO.OF STORIES MAX OCC.LOAD PLUMBING FIRE SPRINKLERS REQUIRED ❑YES ❑NO a MECHANICAL COMMENTS STATE BLDG.CODE 7 55 ENERGY CODE SURCHARGE PENALTY U B C SEC 303(a) V S I'1 1 C I L Y WATERISEWER FEES TOTAL PERMIT VALIDATION ^1, WHEN PROPERLY VALIDATED TIN THIS SPACE)THIS IS YOUR PERMIT&RECEIPT PAID CR# BY Y cc ASSESSOR,APPLICANT,TREASURER, BLDG DEPT BUILDING OFFICIAL DATE APPLICANT'S COPY CITY OF ARLINGTON CONSTRUCTION PERMIT ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO. MAIL ADDRESS CITY ZIP PHONE ARCHI I ECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE# PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N CLASS OF WORK ❑NE WA ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑BUILDING RELOCATION VALUATION OF WORK S DESCRIBE WORK PROPOSI D USL OF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- LLGAL UESCRIPTIUN OF PROPERTY(SHOWN Elf AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK LOI BLOCk OF WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITYTO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR TAX ID NUMBER LOCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF CONSTRUCTION. PERMIT EXPIRES I YEAR FROM DATE OF ISSUANCE. 108,\DDRLSS SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE X (OFFICE USE ONLY) PLUMBING MECHANICAL NO. TYPE OF FIXTURE FEE NO_ TYPE OF EQUIPMENT FEE WA IER CLOSET (TOILET) AIR COND.UNITS - H P EA BAIH1UB 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 U MEA DISHWASHER WALL HEATERS- B.T U M LAUNDRY TRAY UNIT HEATERS - BTU M CLOIHLSWASHLR EVAPORAI IVE COOLERS WAILR HEAT LR ' CLOTHES DRYERS URINAL I VENTILATION FAN DRINKING F OUN I AIN RANGE HOOD COMMERCIAL I LOOK DRAIN AIR HANDLING UNIT- CPM VACUUM BREAKERS STOVE ROOF DRAINS RAINLEADERS METAL FIREPLACE &CHIMNEY SINK (SERVICE - BAR,ETC.) WATER HEATER GAS PIPING SUB TOTAL f SUBTOTAL f PERMIT S PERMIT f TOTAL FEE $ TOTAL FEE $ SILA YARD SE I BACK STREEI SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE FEE RECEIPT NO. USF /ONF LOT AREA VACANT SITE ❑YES ❑NO FEES VALUATION FEE l ti PL OF CONSI OCCUPANCY GROUP NO.OF DWELLING UNITS PLAN CHECKING NG SIZE OF BLDG NO OF STORIES MAX OCC.LOAD BUILDING $ i) 71 PLUMBING FIRE SPRINKLERS REQUIRED ❑YES ❑NO MECHANICAL COMMENTS STATE BLDG.CODE I ENERGY CODE SURCHARGE PENALTY U.B.C- SEC 303(a) WATER/SEWER FEES TOTAL PERMIT VALIDATION _ WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT&RECEIPT PAID CR# BY cc:ASSESSOR.'APPLICANT, TREASURER, BLDG DEPT BUILDING OFFICIAL DATE ASSESSOR'S COPY