HomeMy WebLinkAbout4611 196th Pl Ne_BLD5701_2025
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
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BLD5701 Residential Mechanical
4611 196th Pl Ne December 2023
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RESIDENTIAL MECHANICAL APPLICATION
Community and Economic Development
City of Arlington • 18204 59th Ave NE • Arlington, WA 98223 • Phone (360) 403-3551
REV03.2022 Page 1 of 2
This application is for new, addition, altered or replaced mechanical installation and new or altered gas piping. Please fill out all pages of this application and include all information.
• New gas piping requires a pressure test hooking to any appliance
• Sediment traps (drips) are required on all gas lines
• Gas lines are required to be supported/secured every 6 to 8 feet
• Proper Combustion air and venting required for all appliances
• A shut-off valve is required within 6 feet of all appliances
MECHANICAL PERMIT FEES (per unit)
Additional Plan Review fees x $ 75.00 = Air Cond. Unit ≤100Btu/h x $ 15.00 = Air Cond. Unit >100Btu/h x $ 25.00 = Air Cond. Unit >500Btu/h x $ 50.00 = Air Handling Units x $ 15.00 = Base Mechanical Fee 1 x $ 25.00 = $ 25.00 Boiler <100Btu/h >3hp x $ 15.00 = Boiler >1 million Btu/h<50hp x $ 25.00 =
Type of Permit: New Installation Addition/Alteration/Repair Gas Piping Property Address: Project Valuation: Lot #: Parcel ID No.: Preferred Contact: Owner Contractor Project Description: Owner Name: Home 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:
Gas Piping Information Not Applicable Proposed Piping Material: CSST Brass Other
Black Steel Galvanized Steel _______________________________________ Proposed Piping Size: ½” ⅝” ¾” 1” 1½” 2” Distance from Meter to furthest Appliance: Total BTU’s of all Appliances:
4
4611 196th Pl NE 3200
00951300000300
REPLACE GAS FURNACE
Jerry Halsen (425)327-6061
jah636363@gmail.com
4611 196th Pl NE Arlington wa 98223
Washington Energy Services
PERMITS@WASHINGTONENERGY.COM
3909 196th St SW lynnwood wa 98036
WASHIES851NS 9/7/25
4
REV2.2020 Page 2 of 2
MECHANICAL PERMIT FEES (per unit) Boiler >1.5 million Btu/h<50hp x $ 50.00 = Boiler >100Btu/h 3-15hp x $ 15.00 = Boiler >500Btu/h 15-30hp x $ 25.00 = Commercial Hoods -Type I x $ 25.00 = Commercial Hoods -Type II x $50.00 = Diffusers x $ 15.00 = Dryer Ducting x $ 15.00 = Ductwork (drawings required) x $ 25.00 = Evaporative Coolers x $ 15.00 = Exhaust/Ventilation Fans x $ 15.00 = Fireplace/Insert/Stove x $ 15.00 = Forced Air Heat ≤100 Btu/h x $ 15.00 = Forced Air Heat >100 Btu/h x $ 25.00 = Gas Clothes Dryer x $ 15.00 = Gas Fired AC ≤100 Btu/h x $ 15.00 = Gas Fired AC >100 Btu/h x $ 25.00 = Gas Fired AC > 500 Btu/h x $ 50.00 = Gas Piping ≤ 5 units x $ 15.00 = Gas Piping > 5 units (plus <5 units) x $ 2.00 = Heat Exchangers x $ 15.00 = Heat Pump-Condensing Unit x $ 25.00 = Hot Water Heat Coils x $ 15.00 = Miscellaneous Appliance - regulated by mechanical code, not otherwise specified x $ 15.00 = Pkg. Units ≤100btu x $ 25.00 =Pkg. Units >100btu x $50.00 = Range/Cook top-Gas Fired x $ 15.00 =Refrigeration Unit ≤100Btu/h x $ 15.00 =Refrigeration Unit >100Btu/h x $ 25.00 =Refrigeration. Unit >500Btu/h x $ 50.00 =Re-inspection fee x $ 75.00 =Residential Range Hood x $ 15.00 =Unit Heaters ≤ 100 Btu/h x $ 15.00 =Unit Heaters >100 Btu/h x $ 25.00 =VAV Boxes (Variable Air Volume, part of air conditioning system) x $ 10.00 = Wall Heaters - Gas Fired x $ 25.00 =Water Heater - Gas Fired x $ 25.00 =Permit Fee Inspection Fee $75.00 Processing/Technology Fee $25.00 Total
1 15.00
REV2.2020 Page 3 of 3
PRESSURE PIPING SCHEMATICCOMPLETE FOR GAS PIPING ONLY
SCHEMATIC IS TO SCALE SCHEMATIC NOT TO SCALEShow Pipe Size(s) and Length(s) from meter to all appliances
NOTE: Any interior pressure regulators must be indicated
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. A final inspection and approval shall be obtained
when complete.
Signature Print Name Date KAREN MATHENEY 11/15/23
SAVE PRINT