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Home My WebLink About210 E Burke Ave_BLD056634_2025 INSPECTION REPur- rc Ah ii T Permit No.: 4'// Lot #: Address: - 1 %A�� Contractor:Owner: Date: f C `� 7APPROVAL ❑ 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• 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 4Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: E�►m INSPECTION REPORT ¢ti1N GTO Permit No.:c��..� 3Ss' Lot #: 4' Address: yck. e il(eiA3 _6 � Z Contractor: 4 Owner:,3r9 wi 940' ING'N Date: L4--0 I PPROVAL ❑ PARTIAL APPROVAL ❑ OLATION ❑ 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: Zo Date: T E 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 ,¢D4C' Permit No.: � � LotAddress:Contracto :OwnerDate: ie9l 9' ,. ❑ 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. r VV Inspector: Date: /` 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 0 Insulation ❑ Other: G%� INSPECTION REPORT �ti1N OHO Permit No.: Lot #: Address: �w-k'c Contractor: Owner: .4ede- 8nispy SIN O Date: — _ ROVAL ❑ 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. I'� 3D C 2JP� Inspector: Date: 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 3XFinal ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: INSPECTION REPORT 4ti1N G TO Permit No.: Lot #: 4' Address: Z Contractor* C_I�>cl O Owner: gs4IN G� Date: C%/ y3 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. AS 1 `LC bat- Inspector: Date: _ Q TYk OF INSPECTION REQUESTED ❑ Under-floor ❑ Gas Piping ❑ Footing XFraming ❑ Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: INSPECTION REPORT ¢titN GrO Permit No.:( — Lot #: 4' Address: � Z Contractor: 0 O Owner:IN G� Date: ❑ APPROVAL ❑ PARTIAL APPROVAL I6LATION ❑ 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. 00 ol Inspector: L2 Date: 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: I -IF )r C)F=- (--A FR I I P4 C3-r U tq C3 tN4 E3-F Ft U(---IF I C " Fz),1—= FR M I -F F-:7-FZ M I -F IqC3 go t5—6 CE). Z314 Owner: BRYSON, GENE 515 N OLYMPIC AVE HE ARLINGTON 98223 Value of Work: $500. 00 Tax ID: 004618-015-006-00 Phone: 360 435-0700 Describe Work: INSTALL CHANNEL LETTER SIGN Proposed Use: RETAIL OFFICES Legal Description: HALLER CITY LOT 6, 7, 8 Job Address: 202 E BURKE ST Contractor's Name Type Address License* APOLLO NEON GEN 14721 16TH AVE NW APOLLNI0440D TOTALS Fee Permit Fee $29. 31 atakw\ State fee $4. 50 SIG A E: 8 TOTAL FEE. . . . . . . . . . . . . . . . . $33. 1 1 H R BY CERTIFY THAT I HAVE READ AMD ' AMINEED;TT?HIS APPLICATION AND PAYMENTS. . . . . . . . . . . . . . . . . . $0. 00 KNOW THE SAME TO BE TRUE AND COR- REC'T ALL PROVISIONS OF LAWS AND TOTAL DUE. . . . . . . . . . . . . . . . . $33.81 ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER Sp5z,--IFIED HEREIN OR NOT. DATE RECEIPT # ErUILDING OFFICIAL --7 OA\ o v -i 0 V� rMtm z of PLU RECEIVED JAN 2 6 2001 CITY OF ARLINGTON , . . . � a . �. . . . . . . � � |. . . � . \ RECEIVED JAN 2 6 2001 CITY OF ARL NGTON a k ' O �l6ti C/T/Ale 1^7"1 a /a" latwne C9se Aelfelzs, l A *e-, axme l /I'ds-t,e - ee r31,? /yldvArted to rr9)4 &,,I JNsIL11t1Vy S—YAyl.�'aeQ+' C-) 61oe 0.4 RECEIVED �w JAN 2 6 2001 == e e? CITY OF ARLINGTON 11�u1�/�,lp gL�PL �-YvL1�L DPl1 ��If'PR ,c z1 -�uuu iu : ub FN Ri " ARD LAWSON 206 526 5615 P• 03 \ I 7 1 f r - I /1� ot 1� 71 -7-o M14hl WALL— a� N \ 1 lof V� lac 60•"� - w ( �� ., -RECEIVED SM � NOV 2 2 Z000 citimort a e g � CITY OF ARLINGTON CD — 4135� err-C1 -000U IU ; Uf t'CI 206 526 5615 P, 02 o- e v .7.0- dc 6vn5pour5 in a S Q s Si Q A b I GM LOG FiMrLACL- . n ti N t � T FVrME .TENANT ENOrES DEMISING,WALL , I rr-"- i AO ONiaiins voo 500Z 9 0 d3Scr ONK) i V� � o :^ ►� NJ --� rm+ rfn ryn w men L1 I �r� O n d 1 r-� t 09/06/2005 10:55 3607946177 SIGNCO PAGE 01/03 9/6/05 The sign is manufactured from framed PVC. The sign is glued onto the wall with 3/16" aluminum studs and glue pads. **see attached** The re-placement sign is not illuminated. However the goose neck lamps illuminate the sign. The new sign is 134" wide by 10" high for a total square footage of 9.31 square feet. The building street frontage is in excess of 360 square feet. RECENED SEP 0 6 100T C®A BUILDING DEP 09/06/2005 10:55 3607946177 SIGNCO PAGE 02/03 Callfor Free Installation DVD, CD, or VHS lap INSTALLATION Or visit fo r I o PLAIN INSTALLATION lb FLANGE INSTALLATION FLANGE is flat,3/16"LoIfV perinictur on the lettet reqirn which lio)e,5 can be drillrd,kckii-c with screws or nails. V flaiige available: upon request. Not recommended for (c ruder G". Plain mounr Teucrsare shipped withouL mounting harawartf. 20 STUD INSTALLATION STUDS-arc metal kc�ided lio,is,on the.rear 01*the lettm. 8 itud lengths of 1", 1.1,12',2",3",4".i`anti 6". specif,if need to be in line I'm-brick of block wall womr jc)irirs.(Brio: 50 on ctrirtr;bkx-k on centm z Alwa check M le the shop! A. 1. CI)cck pattern in shop FIRST! S. 11tric one edge or the template to the wu5taliarion Z_ Mark brilts with center punch,then d( wfitcc with maskhig tape anti unroll It. Level the holes 3 inches deep wtere indicated on you template and tape the other edge to the installation plate.Remove the template and clean out; ly surface. holes wing any of the following methods: . puff of air; u.s tng the vents on your drill pressed Air or-it narlicy baiter. ......... ... 4. Insert the studs into the scud bolc%on the back- Push the tube of silicone over each mid on the Push the letter into the drill holes using of each letter.Place letters in holes on wall Write first letter in order to evenly curt it with adhesive. .sure the proptrsmadolf of the few om t applying trp,0 through i for the rest of the I silicone to verify position,Adjust nccc.i- Rcpeat s sary.Now 69 the drill[toles in the wall of the First "' letter with silicone. 102 09/06/2005 10:55 3607946177 SIGNCO PAGE 03/03 PAD INSTALLATION PADS are plastic rliAs on the rear of the letter... Secure the letters to the wall with silicone adhesive(paFc 101).Adjusiable or flush palls av:iilablt:uivii request. Pid mount only recommended on Iettm.,I:ss than 24"tall. I ,.�• �'I',I ,fix i.:. '., � ' Sri C :Iran the installation surface first. Position the 2.Apply silicone to all of the pacls on the first let- 8. Adjust as needed; push letter against wall to in;tape on the wall and secure one end with ter.Position the(titer on the wall where.indicated insure good adbesioe bond. Continue with the ung tape.Unroll,level and tape the other end. on the spacing tape,Tape the letter to the wall with remainder of the Ic4ers,and allow the silicone to ing tapes show the general posldon of each let- several snips of masking tape. cure for at least to minutes before remoting the mly and are available free upon request. masking tape. However,we recommend overnight curing for mast conditions and silicones. COMBINATION INSTALLATION i t COMBINATIONS have pads al the bottom and pa Wstuct combinations at the top of the Ict- i ter.Specify if scuds need to be in line For brick or block wall molar joints.Not for letters I k under 6". Follow immicdons 1-5 of stud mount method for top studs and fallow 1-4 of pad mount for hntrom pads. COMBINATION ALL INSTALLATION ' COMBINATION ALL letter:have stud through pads on all mounts. Specify if studs necd to If ( lie in Ijnc For Frick or block wall mortar joint,.Not for Idlers wider G'. t RI Follow instrucrjons for stud mount. Apply extra silicone.on stud-thru-pad in step#6 ru :adhere pad to mounting surf;fce.Always clean surface before using silicone. ERNATIVE FORMED PLASTIC INSTALLATION BRACKETS:ire WINES:av slauiiais FREE STANDING 11110111IIIIIIIIIII FOAM FILLED T.-shaped plastic steel hooks incited Ica rs have 9(r letters are ollcd proicciitms flared info plastic blodts ntrntnting Brack- with rigi 1 urethane nuror rtl frona glued ro inside of ms for installing foam and cut Flush buck of the,letter. letter.Aailahle for a tin rou&'.Orher -- fo the hack edge of fhlsh nt(=Wae or angles available the letter.Available vwth r',1" Wf'or b upon reyuast. ftm leact,9"and 2"snauloris on flat Price Is a times smaller.Price v 3 fxed0m,,(Tand up, once 14atetl. time.price listed. FSignletters-com 1-800-LETTERS 103 MARKET F'] STREET MO RTGAG E The easy way home° 1 2�CL t3 Proms b•-� �-2je-4EF - Z !o G>�J 2- r' jxb.`S p ca.� i � 97 L 70q ,GAS F 7 Le UM SEP 0 6 7005 www.marketstreetmortgage.com Y MARKET F-, STREET MORTGAGE The easy way home° ^ C`\ a a, S / �. �.a k www.marketstreetmortgage.com 09/06/2005 09:01 3607946177 SIGNCO PAGE 02/02 �% Y °4 SIGN PERMIT 9� o APPLICATION �ING� Department of community Development City of Arlington • 238 N Olympic Ave. -Arlington,WA 98223 - Phone (360)403 3431 -FAX(360)403 3447 THIS APPLICATION MUST BE ACCOMPANIED BY TWO(2)SETS OF COMPLETE PLANS,INCLUDING STRUCTURAL CALCULATIONS WHERE APPLICABLE, TWO(2)FULLY DIMENSIONED PLOT PLANS IF APPLICABLE. Project Address: ' So 5 r " Parcel 10# 0() LA 6, o - 1 S -006-0 0 Lot#: G I� Subdivision: �1 ALl,�A Lt N- L_ULK �1S uG��J L- �2�cOa-� ffi4LL�YC. G iT, /n:U_ Owner: - --Phone Number. Address: City: State: 4.&'A Zip Code: Contractor: Phone Number: de;�,aefi P ►e-K Cell Phone: Fax:360 zf'S/ 4 i 7 E-mail:-1#,y G 360 Xf A1Y Address: A*a602- SS,1k 10-F City: A1PA' /.414P! State: bp" Zip Code: 27� Contractor's License Number.A P G LL AJ 10 yyO Z> Expiration: 9'V—4�6 WALL SIGN CALCULATIONS MONUMENT SIGN CALCULATIONS Height of wall Total street frontage in feet Length of wall 0 Height of proposed sign Area of wall p 91 Width of proposed sign Height of proposed sign Total sign print area Length of proposed sign 13V ' �c IP'" Total sign structure area Area of proposed sign 9,3/ sQ"1~ I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the above-described property will be in accordance with the laws, rules and regulations of the Stat of Washington. Appl nts Signature Vale Print Applicants Name RECEN SEP 0 6 2005 Forms/SIGN-1 W. A BUILDING DEP C I -rY OF=' ARL I NGTON CONSTRUCTION PERM I T HERMIT' NO_ 01-4+41S Owner: i=ETERSON, DON 202 EAST BURKE ST ARLItdGTON 98LEG Value of Work: $1,000.00 Tax ID: 004618-4'10-006-00 Phone: 360-4O3-7102 Describe Work: FORMED PLASTIC LETTERS Proposed Use: OFFICE/MORTGAGE Legal Description: Job Address: E0E E BURKE Contractor' s Name Type Address License# RGN GENERAL CONSTRACTOR GEN PO BOX 713 NORANC*066RG TOTALS Fee Per mill Fee $30.00 SIGNATURE: Cv�-. TOTAL FEE. .. .... . . .. ...... $30.00 I HEREBY CERTIFY THAT I HAVE READ AND E AMED THIS APPLICATION AND PAYMENTS.. . ... . . . .. . . .. . ..$0.0 KNOW - IN E SAME TO BE TRUE AND COR— REC T A L F'R I S i ON ' OF LAWS AND TOTAL DUE..... . .. ...... . .. $30.00 ORD ICES VERNI T S TYPE OF WiJR JILL C M . - D TH. WHETHER SrIE i QED I IN DATE RECEIPT # AA !. I1�G FIC A SEN 21 -2000 10 : 08 PM RICHARD, LAWSON 206 526 5615 P. 03 aLY' 1+ •� � w x N�' _ �;o" MIEN WALLCD N � I c6o n �(j ■ 'f 79 N , JA --�-■—R E C E t V E D �1 SAA NOV2 2 Zo®� cite mortgage �4 ": CITY OF ARLINGTON CD 5S-5 �ti�-C1 -0000 lU : U1 FMKICHAKJ, LRWSON 206 526 5615 P l' • 02 dc wmpoum hN a s s+v N a ti • N FVrAE .TENAr7 T in ENOTE5 DEM151NG WAIL T rT i w C-C ►O Aq CITY OV €kRL I N+C7Y0N CONSTRUCTION PE:RM I T PERMIT NO- 0 00—.4355 Owner: BRYSON, GENE 515 N OLYMPIC AVE NE ARLINGTON 98223 Value of Work: $10,000.00 Tax ID: 004618-015-006-00 phone: 360 435-0700 Describe Work: TENNANT IMPROVEMENT Proposed Use: OFFICE SPACE Legal Description: Job Address: 202 E BURKE Contractor's Name Type Address License# RGN GENERAL CONSTRACTOR GEN PO BOX 713 NORANC*066RG TOTALS Fee Permit Fee $181.25 Plan Fee $117.81 State fee $4.50 SIGNATURE: TOTAL FEE................. $303.56 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND PAYMENTS..................$0.0 KNOW E SAME TO BE TRUE AND COR- RECT A PROVISIONS OF AWS AND TOTAL DUE................. $303.56 ORDI A ES VERNI G T S TYPE OF WOK WI L B COVED' r ED TH WHETHER SF' F D� H "E NO DATE RECEIPT # �� _�.�.__. io BU L i G ciAL p�2�� Must submit: 4 cc 'es of drawings & 4 copies of i; allation directions CITY OF ARLINGTON SIGN PERMIT ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING SIGN PERMIT N0.pI-g419 I OWNER MAIL ADDRESS CITY ZIP PHONE W l��fcf{5o.t> 9si dvzee Sr p»s4 W'22-3 .40 Z153 Ile A ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE �GF.NjRpLC�RACTUR MAIL ODRESS CITY LIP PHONE LiC NSE/ MLCIIANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE CLASS OF WORK co❑NI W ❑AUDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑BUILDING RELOCATION /moo.(/ a VALUAI ION OF WORK z S �Ql�d Icy] DI.SCRf8L WORK T F- m PROPOSE D USE OF BUILDING CA /� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- w 0.?,ect e TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- JLEGAL UESCRIPTIUN UT PAUPER ( OWN BELOW UR ATiACH FOUR CUPIf.S) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK J LOI BL(X K • OF WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE < GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO Li `1 �-' S r`'� VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR OwJ TAX ID NUMBER FROM PROPERTY TAX STATEMENT LOCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF CONST PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE. 108ADDRLSS ` V 'e� S.`— X RE OF CONTRA OR OR AUTHORIZED AGENT DATE %1!'PL1CA'I'lUN I5 lIt3R1313Y MAU13 FOR 1'I3RMiSS1ON '1'O ERl3G1' ( ] ALTER [ ] REPAIR [ ] PROJECTING [ ] THMPORARY [ ] GROUND [ ] ROOF W WALL [ ] O'1111?It, DESCRIBED AS FOLLOWS: SIGN of a type similar to that checked and described below, fastened and Secured by approved &tippoius, and I: is heYevy agreed Hint .f thib ap'-11--nilon is app.ro ed tltq -0.ggn will cottfornt in every detall with the requiremettis of Ilia Building Code, Sign Code, Zoning Ordhtance and all City Ordinances and State Law. Sign will be: [ ] 111utrtinated [ non-illuminated [ J plain wood [ ] electric Size: Wgl. /& lbs length /U' widllt le face w sq ft Face area: Sq. ft. Sign is�2'face(I: distance from N S property line: 13 W Lower edge will be /U 1 feel 6J1 incites above grade. liner edge will be / " Inches from lice building. Outer edge will be A E• inches from the buitdittg. Lower edge will be feet (aches above rite alley, sidewalk or private p&perty grade. Sign will extend feel Inches above lire building. Of what material will ilia s' t be constructed? I?ace: eVeer , reRme l .11-s-6C-- I'raitte: _ 5 li Wording of sign C/Ti1"O(ejZ- qdqC. E.Poc o(nee us*only l O r AL PEP, 1 U 1 AL MIS SIDL YARD SC 1 BACK STREET SL T BACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE FEE RECEIPT NO. USE /ONE LOT AREA VACANT SITE ❑YES ❑NO FEES VALUATION FEE TYPL OF CONS]. OCCUPANCY GROUP NO.OF DWELLING UNITS PLAN CHECKING VG S1/L UI BLOC,. NO.Of STORILS MAX.OCC.LOAD BU'LDING S PLUMBING f IRE SPRINKLERS REQUIRED [-]YES ❑NO MECHANICAL COMMENTS STATE BLDG.CODE ENERGY CODE SURCHARGE PENALTY U.B.C. SEC.303(a) WATER/SEWER FEES RECEIVED � � �^p TOTAL ![ /�' PERMIT VALIDATION `]pN 2 g 2001 �! WHEN PROPERLY VALIDATED(IN THIS SPACEI THIS 11 YOUR PERMIT 6 RECEIPT ®' PAID CRR BY CITY OF ARLING c ASSESSOR, DEP'F K 3ttliRvedC0+K 1�� {` CITY OF ARLINGTON CONSTRUCTION PERMIT CIO ❑ COMBINATION BUILDING ❑ MECHANICAL PLUMBING ❑ SIGN PERMIT NO. j OWNER ppii CCIn MAIL ADDRESS CITY ZIP rHONE ARCHITECT OR DESIGNER 1 MAIL ADDRESS CITY ZIP PHONE �Ql�CU//I Ay-dLite'eS `ASOO Lc�kzS re (11"A ML StAvv - 't"S S GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE II L2�/V P_0 . CcX -111, C,;Nl4,A'i (1�S231� &(-)?,Ave-*c6ERG MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE/ 9� c, PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N 3 CLASS OF WORK 0❑NLW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLI f ION ❑BUILDING RELOCATION�c ,,.,11 f/ Z"41^OL,1441UL Q VALU,�IONOf WORK 7 z s IT10 W DESCRIBE OORK / 3 "PC G' w12 r��>r ?ter✓i��5 �i�1 m PROPOSt D USE OF BU DING to I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- Lu TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- Z LLGAL OLACRfPf ION Of PROPERTY(SHOWN BELOW OR ATTACH FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK J LOI��RLOCK—.1�S=0T 4ALk-F-k Ci T i WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE a GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR a. TAX ID NUMBER FROM PROPERTY TAX STATEMENT LOCAL LAW REGULATING CONSTRUCTIONOFTHEPERFORMANCEOF a. CONSTRUCTION.PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE. VSIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE JOB ADDRI.SS 1 &A-rk-e x -% (OFf'icE USE ONLY) PLUMBING MECHANICAL NO. TYPE OF FIXTURE FEE x'a FIXTURES NO. TYPE OF EQUIPMENT FEE x'a FIXTURES \ ATER CLOSET ILur COND.UNITS—H.P. EA. 3qtip.list•• A111TU6 EIRYGFRATION UNITS—H.P.BA tip.list•• VATORY ASII BASIN OILER-H.P.EA. igtip.list** IEOWER jAS FIRED&C.UNITS—TONNAGE EA. 3qtip.list** 1TCHEN SINK.&DISPOSAL TORCED AIR SYSTEMS—B.T.U. MITA ISHWASFIER NALL HEATERS—B.T.U. M -AUNDRY TRAY JNIT HPATERS—B.T.U. M LOTHES WASHER lVAPORATIVRICOOLMLS ATER HEATER LOTEEFS DRYERS RINAL VENTILATION PAN KINKING FOUNTAIN GE 1100D COMMERCIAL ILOOR DRAIN OUR IIANDLING UNIT— CPM VACUUM BREAKERS OVE OOF DRAINS—RAINLEADERS 11EiIAL FIREPLACE&CHIMNEY INK SERVICE—BAR,ETC. ATER TIE-ATER AS PIPING *(up to 5-$3.00,addnl. S35 ..Equipment list must be provided SUB TOTAL \\ SUB TOTAL PERMIT PPAMIT TOTALFEE TOTAL FEE SIULYARUSLIBACK STRLLISLIBACK REAR YARD SE TRACK PLAN CHECK NUMBER PLAN CHECK FEE FEE RECEIPT NO. USF /ONE LOT AREA VACANT SITE ❑YES NO FEES VALUATION FEE IYPL Of CONS'. OCCUPANCY GROUP NO.OF DWELLING UNITS PLAN CHECKING NG SILL Of BLDG. NO.OF STORIES MAX.000.LOAD BU'LDING f PLUMBING f IRE SPRINKLERS REQUIRED ❑YES ❑NO MECHANICAL COMMENTS STATE BLDG.CODE ��— ENERGY CODE SURCHARGE *--� U.B.C. PENALTY SEC.303(a) RE C C S VE D WATER/SEWER FEES C+ TOTAL Nov 2 2 2000 PERMIT VALIDATION WHEN PROPERLY VALIDATED TIN THIS SPACE)THIS IS YOUR PERMIT&RECEIPT C!]y OFgRUNGT0N PAID CRN BY cc: ASSESSOR,APPLICANT, TREASURER, BLDG. DEPT. BUILDING OFFICIAL DATE RECORDS COPY