HomeMy WebLinkAbout216 E Burke Ave_BLD14250_2025 City of Arlington
Permit No.
- NOTICE and Inspection 1port
:D~ate Called ~ h I' I
O Setback O Reroof O Insulation
0 Plumb GW O Roof Diaphragm -f/Gas Pipin~.
O Footing ~raming O Woodstove
O Foundation O Drywall Nailing O Final
O Concrete Slab ~ Bouqh-In Plumbing O Reinspection
~hear Wall O Furnace O Other _
â–¡ APPROVAL â–¡ CORRECTION REQUIRED
O Corrections listed below MUST BE MADE before work can be approved.
D Work listed below has been inspected and approved.
0 CALL 435-0724 FOR RE:INSPECTION - 24 hour notice required.
Permit No.
Date Called
â–¡ Setback â–¡ Reroof D Insulation
â–¡ Plumb GW â–¡ Roof Diaphragm D Gas Piping
â–¡ Footing â–¡ Framing D Woodstove
â–¡ Foundation â–¡ Drywall Nailing D Final
â–¡ Concrete Slab â–¡ Rough-In Plumbing einspection
â–¡ Shear Wall â–¡ Furnace
:AR!:_ROVAL â–¡ CORRECTION REQUIRED
D Corrections listed below MUST BE MADE before work can be approved.
~Wo~ted below has been inspected and approved.
0 CALL 435-0724 FOR RE:INSPECTION · 24 hour notice required.
BUILDING PERMIT APPLICATION CHECKLIST
RES &DUPLEX COMl\1 & IND
APPLICATION APPLICATION
SITE PLAN SITE PLAN
ARCH.DRAWINGS ARCH.DRAWINGS
STRUCT DRAWINGS STRUCT DRAWING
LEGAL DESCRIPTION LEGAL DESCRIPTION
ENERGY CALCS ENERGY CALCS
STORM DRAINAGE STORM DRAINAGE
SEPTIC TANK DESIGN SEP A CHECKLIST
UTILITY DRAWINGS
STRUCT CALCS
THREE (3) COPIES OF EACH FOUR (4) COPIES OF EACH ARE
ARE REQUIRED FOR APPLICATION REQUIRED FOR APPLICATION
ZONING SETBACKS: FRONT
USE REAR
LOT COVERAGE SIDE
---=---=---==--==-=--z----=-------------
PERMIT TRACKING
NameCJJu.1,Y\l R'z.N~ i:!"tl Permit# ------
Project Type A L,1" e~ Date Received 4- -/ H Lf
DISTRIBUTED RETURNED DISTRIBUTED RETURNED
--~ks _ ~g-
Jo~s _
~
Date Returned for Corrections ,ll//,4-
1
Date Resubmitted with Corrections Made
Date Ready to Issue <{/-IS" 41/ Date Issued ~
I
DATE: /Ji)/ SIGNED: ¢./~41
lwp5 I \sherri\Checklist.BP
)
City of
ARLINGTON
Building Department
PLANNING AND ZONING REVIEW
I. ZONING COMPLIANCE:
A. Zone Classification --
B. Permit Use: Yes No
C. If no, extension of non-conforming use: _
D. Minimum lot size required: __
Shown: --
E. Yard Requirements:
Required Shown
1. Front _
2. Side ------
3. Rear _
F. Height limitations, Maximum _
G. Landscaping and plan required: Yes_ No
H. Parking:
1. Off-street parking required: Yes _ No
2. Plan provided: Yes_ No_
3. Adequate parking provided: Yes_ No
II. LOT COVERAGE
A. ALLOWED: __ MORE/LESS _
SHOWN: ___ APPROVED
___ NOT APPROVED _
DETERMINATION OF S.E.P.A. CATEGORICAL EXEMPTION
Action I Application Title: SFR Brief Description of action: EXEMPT
Code reference allowing exemption: w.A.c. 197-11-soo 1 (i) b
Person making determination: _
Date: _
lwp5 l \sherri\BP-SEPA .frm
,
,~~/
- -- Q,.,r
•-·------ -- ~~r
'
----- --~
-· --------· . ---(
--- ------ ---- - .(
I
----- ........_......_. __, I ; ----- - -------- -
----•--· ·•···•·-·-
' '
---11- - _- :
5'-
-· --------- -·----- - ----- -1
-- 1~e-t~ /IJ_~ - -- :,
- ..... --- -- .. +-t------------"f--~---,-!
- - ·- --· - -- -· - - ----- - - ··-- _?~~.(.'- - - ----- - ----. - --
- ---- ·----~-~ '____ __ _ tJtLtt_e_f- _ __ _ I
------ ·-- ----- - ----·----:---c.arp,r-t----------- -------- -- ------
~--- ---- ------ --,------
--+-------=--=.,,,,,,._=--=----------,-- -------- ---
-- - . - -- -- J
I
--- ----;----·- --------------------
-------·-·--· -- _-_ - -~ - --~ ~:~- .. - -~-~~-- -~~~~=-~- _-------~--§?~-----·---~--~- ~- - - -- - -- ~---~ ----- -- . - -_ - - __ ·----
' ~ ... , ' - - - -··-.
----------- - -- ..... t - • --- • - . --- --- - --·-· ~ '!!! .. - -- .. - -- - - - ---- -· - -- --·- -- ··-
~
r~ - -- _--~- -~- : ~:- __ - . - --- -- __ - ---
~- -_ -
" .
J\ . -· . ·- - - - . - --
- ' --
-• -~-·-- - . -- ,
__ ·--~
-·---"- - . ...... - -~- - - - .. - •· -- - --- --- ---- --- -
-- ·-·--
·- 1
I '
- ·----·-----·-- - -- -- -· .!... ... -- - - - --
---- -·--·- ---- --- :------ -··----- -!--- - - - ·- -- CITY·O · 1 RI INGTOr\i'·- - ·- - ---1
-:--- 1
J_ _i__~_,;;...r,,c_ ' -+----- -·-------- --
_, __ . __ --- -· ----. - -- -- . -- Al/et---· -- .. --- --- -- - - - -· --- ·i
I
..
vJILDING PERMIT FILE CHECKLI~ ..
Applicant Name Job Address _
___ Legal Description on file NI A _
___ Plans Requirement Checklist __ Completed NI A
___ Planning and Zoning Review Completed NI A
___ Energy Calculations - WSEC __ On File NIA
___ Field Inspection Record - Job card issued _
--- Site Plan - On File NI A
___ Copy of Plans - On file _ Hanging
___ Health Department Approval - On file __ NI A __
___ S .E.P .A. Checklist - Exempt _ On file_ NI A _
___ Utilities Information Questionnaire & Application - On file _ Existing adequate _ NI A
___ Fire Dept. Appr. NI A _ Comments on file _ Verbal appr. by Date
Time _
___ Airport Commission Approval - On file_ NIA __
___ Eng. Approval - Storm Drainage - verbal approval by Date Time
___ NIA
___ Contractors Registration # Status _ Expiration date NI A
--- Structural Calculations - On file NI A
--- Soils Data - Assumed stable soil On file NIA
___ Certificate of Occupancy - Date issued _ NIA
\wp5 l \sherri\ Tracking .pmt
City of
ARLINGTON
FIRE DEPARTMENT CHECKLIST
PERMIT # ) 4-'2S DATE L//2 y)qy
NAME, ~L.ri V::,. t..e. V\ t£ D,
ADDRESS: I Lo f d . 311~0
BUILDING USE: c-0 :::t£ (a Jct f\-0
OCCUPANCY CLASSIFICATION·
A B E H
I 1 I
I 1 I 2 I 2.1 I 3 I 4 II 1 I 2 I 3 I 4 L1 2 I 3 II 1 I 2 I 3 I 4 I s I 6
I
I 3 IEE~I I
1.1 I 1.2 I 2 I
TYPE OF CONSTRUCTION
I II m IV V
F.R. F.R. ONE-HOUR N ONE-HOUR N H.T. ONE-HOUR N
1 FASF NL l Al .I N"' .,..·-.:<.:lil{Y I ·r '" ~ ... J IIIN:-i 111< l<F11LJII t<.M 1-i '11:-i !JN ~ lb Pl .AN lN l<HI
SITE PLAN: APPROVED v--- DENIED
ACCESS REQUIREMENTS: _
FIRE LANE REQUIRED: YES NO
SPRINKLER SYSTEM REQUIRED: YES NO
HYDRANT REQUIRED:
# OF HYDRANT'S REQUIRED: __
LOCATION OF HYDRANTS: _
FIRE FLOW REQUIREMENTS: _
ALARM SYSTEM REQUIRED: YES NO
KNOX BOX REQUIRED: YES NO ------
LOCATION: _
FIRE EXTINGUISHERS REQUIRED: YES NO
LOCATION: _
ADDRESS AND LOCATION ON BUILDING: d ~ ZI'?_;: c See, rc?,iJ71
~2:tâ–º~ DATEc,~~
\wp51 \sherri\Firefonn
City of
ARLINGTON
UTILITIES DEPARTMENT CHECKLIST
PERMIT# DATE Lf,f{ c'eij
ACCOUNT#-----....,....,,...
NAME: Colvt"r-.. ~ b
;::;-!.3
ADDRESS: d,\lo c SAb 4 LEGAL:-5 /1.S- bk)~ NfJ._;
BUILDING USE: :-5 i:K {a&_dN.) # OF BUILDING UNITS: _
PLEASE NOTE ALL NECESSARY CORRECTIONS OR REQUIREMENTS ON SITE
PLAN IN RED.
WATER METER REQUIRED: YES e:f./.51 NO SIZE
SEWER REQUIRED: YES NO
HEALTH DEPT. APPROVAL: YES NO v---·
SIDE SEWER PERMIT REQUIRED: YES NO
TOTAL DESIGN UNITS REQUIRED: _)__
GARBAGE CONTAINER PAD: YES ✓
HYDRANT REQUIRED: EXISTING
LOCATION: _
REQUIRED
CURB:
SIDE WALK:
PAVING: ~
STORM DRAINAGE: ~
CROSS-CONNECTION CONTROL en. SMITH): YES NO
BACKWATER VALVE (B. SCHLAGEL): YES NO
SPECIAL DISCHARGE INTO WWTP (PERMIT REQUIRED):
COMMENTS OR SPECIAL PROVISIONS: 1(A/'2 .e:@ 7p31 5?~nJ~S: cM(I)
tft?:?£1/ / ~«:(i71.. cv?:I-
UTILITIES SUPERVISOR: \ 4 ~ DATE: ~/6~'9?(
\wp5 l \sherri\ Utilform
- ·---··--- .- - - I ·-•~ -~c? .. ' '. ----·····-·····/-- -------·-•···--·
- - ·-··c· x, ·v,-·N·--D_EfiG EJJ _ .... ,,~~--"--. " .. • - ---- -
--- ---- - l't. '°' I\ ' \. J I\
---------------- ---- ---- -· -- -- 2J~ / ~ e !Jur- K-e.. A- Vf. ~ ~ __ ., . ,«,-11c~-- ,,.IP" -----------
--------~- _lJ.r.l1.¥J.1-i.t:7.n --- ---- ------ -~- -~-------------·-·--- .. ~ ~ A ~
--~--- "-··tJ/J_riuiLS~~~Cci±; . ~- --~-- , t==:==-=-- - -' ✓-~---
,
I
-------!----+--------------;---------- ----- --------~ r------
--------l--------j---~£~tU!f-Re~-1-,/_-t'rtc e. t _ ~ 1
~~Â¥~. J(,.1!~~~'~=1~1_1 ~ 5 _
..... ,.
- --------v- -,~ I -· --~ 5_atl.e_(f-_/(J_!__ _
---------+-_:..__---+----------- i/
, . ,t
-- ------ - ------+-----l----------------->---.L-1--------+----- ------------
, / .
----------+-,------------- -t--··-------------------- ---i.----r-.o---r--·o··-~----t!---d_--- #---- -J..---d-- u,····A· ~ 1 -1~L-~_ ;: ~ /.' -=---~--~-= -- -----------------------=----=--:~=-~-
~=-==~
---·-------------· ~... --- ' ... __ - -· - ····---------·-·-·-····------ •"'c?OaPu:t(rl~ iDf- -----i::- -- ---------
------+------t-----Laq~~t----------+-----4~ -~------------
"'1!:\
---------- ---- ------1------------.::?.- X---------- ----------!----~----
~ ~,
--------··-·-·----, ----·-··-----·- ·----------------··i':)~ --------- -----------·-
..., t
·---·: --. -----~------ -----------------:·----------------- ··•·--·· · --·-_ --------------- -·-··----·f··--···~- ------------------ ----,- ------+--------::_---~:-.-~~~~--
-------------------·-·-•·· ------------------------------- -·-·--·· -· . -------·<::::. --------------------- I--
- --------------- -· . ------- - -------- ---- --- -------- .. -------·-"- · --- ------ . ------ ------------- ----- -------------- -- -- -- ·-·-
- --·----------·------··- -----------------------1----- . --------- ---- -·-·- - ---+- -- --- ----- --- -· - . --- ---------- -- -----. -- --- ·-··· -
- --------- ·--····-··-·--- -·-· -----------------4---------·-----------· ---- ---- ----·-··------ ------+------------ ---- -------·-· - ··-- . ---··
-···•--------- ·--------- -- --·-··---. ------~=~-~---~~-~-=- :~-----. -------------·-···----------~~:=~=--:·- :=-~·::=~~~i~: f fit'¥tB----------=-~=-
. -------------------------- --- -· - - . ·~J~FE l !, +111t. _
--------·-·---·- --··-----·--····. - --- . ----- --- ---- --- ------ ---- - - -- --- - --- --------------- ,- •·*------- ----- __ ..._.__ _
_______ ,.. _;__ -----------------------------~-------·-::rrv·r:r-,iT:C1i\lT3TUr-, ------
-- ·----, .. --------·-·-----··------ -· ·-· --·· A . /t'~ e1- -·------·· --- .... ----- --··--··------·-·--·· ·-·-~·---·-. .----•·- -·· ----·
SS Permit Number \ Y Q S" ~~......._ Fee Paid
BP Number -1 -7 9-1 ------ / l
CITY OF ARLINGTON
APPLICATION FOR PERMIT TO INSTALL SIDE SEWER
7-6-95
DATE
Undersigned applies for permit to install side sewer on the premises in the City of Arlington, Snohomish County,
Washington, described as follows:
Legal Description:
Lot 22 Farmstead Estates
I
The street address of the property is _..,.2 .... ·0_4_1 ... o_S_l_s_t.....,.D_r_i.,..v_e_N.,..E_. _
The owner of the premises is G_r_a_n_cl_v_i_e_w __ C_o_n_s_t_r_u_c_t_i_o_n _
Owner's mailing address ----------------------------------
! I
The dimensions and location of any buildings on the property, and the whole course of the side sewer from the
public sewer ta its connection with the building or property ta be served is shown on the attached side sewer plat
map. i
i
'
The side sewer contractor who will install 'and connect the side sewer is
Address of side sewer contractor -------------------------------
Action of Sewer Superintendent
___ Application Denied , for the following reasons:
_ _._'/._Application Approved -::r-o \ 'f :..,3\ 19~with the following modifications and changes: _
The Sewer Superintendent may require the permittee to furnish him plans pertaining to the application and issuance
of permit. Reference is made to Chapter p.08 Arlington Municipal Code for-ruies and regulations governing side
sewers and connections with the public sewer.
-- CITY OF ARLINGTON -
CONSTRUCTION
PERMIT
â–¡ COMBINATION :g BUILDING â–¡ MECHANICAL â–¡ PLUMBING â–¡ SIGN PERMNIT ? NO: 1425
OWNER MAIL ADDRESS
Cll Y ZIP PHONE
Calvin & Michelle Rengen 216 E Burke Ave Arlington 435-0454
ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE
GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE
LICENSE
II
Calvin & Michelle Reng_en 216 E Burke Ave Arlington 435,...0454
M!:CHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE
ti
PLUMBING CONTRACTOR MAIL ADDRESS
CITY ZIP PHONE LICENSE
II
CLASS OF WORK
QNLW @ ADDITION 0 AL TE RATION 0 REPAIR 0 DEMOLITION â–¡ BUILDING RELOCATION
VALUATION OF WORK
5,000
D!:SLRIBE WORK
add utility- room and remodel bat.hr'oom
PRUPOSt DUSE Of BUILDING
added living space, i:n SFR I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA-
Lll,\L otc~CRIPTI N r PR P ,;, · · . TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROV!-
, - · O O O tRT (SHOWNBELOWORATTALHfOURCOPIES) SIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOFWORK
5 __
LOr_ RLOCK~Of Haller City 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
-::T:-cA-:cX--,-1 =-o_,-N,..,-Uc:-M-:-:B::-::E::-::R:--------------------~ LOCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF
4618-015-005.-0009 CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE,
jO~~~RL; Burke S:N~~~t]i70Re:;~ATE yft[{)q\j'
<OFFICE USE ONLY) I
'
MECHANICAL u
PLUMBING
NO. I TYPE OF FIXTURE FEE NO. I TYPE OF EQUIPMENT FEE
1 IWAHRCLOSEl(TOIU:l) 7100 AIR CON[) UNITS - HP EA.
1 I BAIH!UB 7100 REFRIGERATION UNITS- HP EA.
l I LAVA10RY (WASH BASIN) 7lon BOILERS - HP EA
SHOWL R CAS FIRED A.C. UNITS - TONNAGE EA.
Kl ICl!lN SINK & DISP. FORCED AIR SYSTEMS - BTU. MEA
l>ISHWASll[ R WALLHEATERS-B.T.U. M
LAUNDRY lRAY UNll HEATERS- BTU. M
1 I CLOll!lS WASH!:R 7100. EVAPORA1I1/E COOLERS
1 IWAllRllEAT!:R 2100 CL01HES DRYERS
URINAL V!:NTILATICN FAN
DRINKIN(; FOUN IAIN RANGE HOOD COMMERCIAL
rLOOK DKAIN AIR HANDLING UNIT - CPM
VACUUM BREAKERS STOVE
ROOf DRAINS - RAINL!:ADERS M!:TAL FIREPLACE & CHIMNEY
SIN!\ (SERVICE - BAR, ETC.) WATER HEATER
GAS PIPING
SUB TOTAL 35100 SUB TOTAL
PERMIT 15100 PERMIT
TOTAL FEE 50 l00 TOTAL FEE
Sllll Y,\Rll Sl !BACK STRH T SL fBACK REAR YARD SETBACK PLAN CHECK FEE
DATE RECEIVED
FEE RECEIPT NO.
USf /ONf LOT AR~.A VACANT SITE 4/14_L94 46.80 ?q17n
â–¡ FEES VALUATION FEE
YES ONO
TYP!: Of CONST. OCCUPANCY GROUP NO. OF DWELLING UNITS PLAN CHECKING \JG
BU'LDING
SIL!: Of aux. NO.Of STORILS MAX. OCC. LOAD 12
loo
I I I PLUMBING I
FIRESPRINKL!:RSR!:QUIREll I 50
100
â–¡ MECHANICAL
YES ONO
COMMENTS STATE BLDG. CODE
4 50
ENERGY CODE SURCHARGE
U.B.C. ,,
PENALTY S!:C. 303(.1)
WATER/SEWER FEES --/
PAID
TOTAL 126
5__Q
Remodel only
APR 18 1994
IT & RECEIPT
1-15-qLP
DATE
/
cc: ASSESSOR, APPLICANT, TREASURER, BLDG. DEPT
----~--------------------- -------------
\_,
~
CITY OF ARLINGTON
CONSTRUCTION
PERMIT
0 COMBINATION 0 BUILDING . O MECHANIC. AL . ·□ PLUMBING ' 0 SIGN
PERMIT NOj
~' OW"lE"R '" ~ f\,\.,"-t..lk ,I} ,~,ea MAI'9. L ADDRESS CITY ZIP
l~ ~~ &0r-ke.. ,4,---L, Ar /,r,, , 1-o .,, L,\J
ARCHITECT OR DESIGNER f<.~ a~L ADDRESS CITY
L CONTRACTOR MAIL ADDRESS CITY ZIP
PHONE
LICENSE#
Q.1) 6(1.2u-e..r-
MAIL ADDRESS CITY ZIP
PHONE
LICENSE f
PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE
LICENSE f
~:-,.~• ... -.:!'I
3: 11~morwoi~---------------------------------------------
CLASS OF WORK
~ 0 Nl W @ ADDITION D ALTERATION D REPAIR 0 DEMOLITION 0 BUILDING RELOCATION
~ VALUATIONOFWORK
ffi s .__,, -..:{""' / 00,0 -
W DlS<:RIBE WORK
~ J-.. u t-, 1, C,V\J-.- r-<- ~oJ~I e(; .... +~ l'l!>o
tD PRUPOS! 0 USE. Of BUILDI G
0 \J .)._ 1.__ • t .S (> ~<.(.. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA-
~ ~ v " TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVl-
:J LlLAL Ol!>CRIPTION 01 PROP[RTY {SHOWN BELOW OR ATTACH ~OUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK
::l LUI S' RLUCK l>. or J--t~I l (_r ' WILL BE COMPLIED WITH WHETHER SPEClflED HERIN OR NOT. THE
<t - GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO
~ -'--------------------------~ VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR
~ ,TAX ID NUMBER FROM PROPERTY TAX STATEMENT LOCAL LAW REGULATING CONSTRUCTION OFTHE PERFORMANCE OF
~ ~ [ ~ ()f S' ~ 09 3' _ ooo q CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE.
Q =:--+:c-:-::-::~....1o<C-____.::::.....:..=.._-r.---r:::::,_--::::-'?""<::--...:,_--,--:- _ _,:_ __ ~ SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE
0 JOB AOORLSS f_
f .Szt:i¼.i... C. \ ..tl_ x e_ L,,J. ~ 'f .... IJ-qy-
(OFFICE USE ONLY)
PLUMBING ~l!CHANICAL
NO. I TYPE OP FIXfURE PEE NO. I TYPE OP EQUIPMllNT PEE :1'•
PIXTIJRES
/ ~ATER CLOSIIT (TOILIIT) S7.00 ~IR COND. UNITS - H.P. EA. ~ulp. li,t••
/ ~ATI-ITIJB $7.00 ~EPRIGERATION UNITS - H.P. EA. ~ulp. li,t ..
•1 t,AVATORY (WA'>H BASIN) $7.00 ~Oll.ERS - H.P. EA. ~ulp. li,t ..
~HOWER $7.00 pAS PIRED A.C. UNITS -TONNAGE EA. ~uip. li,t ..
~TCHEN SINK & DISPOSAL S7.00 PORCED AIR SYSTEMS - B.T.U. MEA $9.00
PISHWASHER $7.00 l',vALL HEATERS - B.T.U. M $9.00
!-AUNDRYTRAY $7.00 ~NIT HEATERS - B.T.U. M $9.00
1 t;LOTI-1&5WA'>HER S7.00 I ~VAPORATIVECOOLERS
/ i',vATER HEATER $7.00 3 l:;LOTI-1&5 DRYERS S6.S0
'1RINAL $7.00 jvENTILATION PAN $4.S0
DRINKING FOUNTAIN S7.00 RANGE HOOD COMMERCIAL $6.S0
FLOOR DRAIN $7.00 IA,IR HANDLING UNIT - CPM
!VACUUM BREAKERS $7.00 li!"_OVE $6.S0
~OOP DRAINS - RAINLE'ADERS $7.00 l',{ETAL Pl REPLACE & CHIMNEY $6.S0
~INK (SERVICE - BAR, ETC.) $7.00 !'NATER HEATER $6.S0
~AS PIPING •(up to S = $3.00, addnl. = $.75
I .. Jlquipmcnl list mu,t be provided
SUBTOTAL SUBTOTAL
PERMIT PERMIT
TOTAL PEE ! ii I !
SIUL Y ARO ~l I BACK !>TRHl SLIBACK RE.AR-YARD SETBACK I PLAN CflECK N
USl LON! LOT AR~.A VACANT SITE w
ri-« HES
ONO
lYPl Of CONSl. OCCUPANCY GROUP NO. OF DWELLING UNITS PLAN CHECKING 'IG
BU'LOING $
i-
Sill 01 BU><.,. NO. or SlORILS MAX. OCC. 1.0AD
PLUMBING 50
FIRE SPRINKLERS REQUIRED
MECHANICAL
OvEs ONO
COMMENTS STATE BLOG. CODE I
-4 ~o
ENERGY CODE SURCHARGE
U.B.C.
PENAllY SEC. 303{•)
RECEIVED WATER/SEWER FEES
TOTAL j~
1§0
APR 1 4 1994 PERMIT VALIDATION
WHEN PROPERLY VALIDATED (IN THIS SPACE! THIS IS YOUR PERMIT & RECTIPT
crrv OF ARLINGTON PAID---'- CRII BY
_
cc: BUILDING OFFICIAL DATE
ASSESSOR. APPLICANT, TREASURER, BLOG. DEPT.
RECORDS COPY