HomeMy WebLinkAbout210 E Burke Ave_BLD87206_2025 city of A It L I e 1%T O N PERMIT APoLICATION 57- 2-0�
230 N. OLYMPIC AVE., ARLINGTON, 98223
(206) 435-5785
COMMERCIAL, RESIDENTIAL, MECHANICAL, PLUMBING, GRADING ri
Tax Account Number !_ '�' [J —615 -OZ; 7- 6Cn -?
o ite Address �� �, 1�-L< City LUA (;y A/
Applicant Name !� «i/�1 J--L� �� Phone .?
Mailing Address 2--,( ((�I �i' Y5 (� t� (�- City 4�' IN( 7?' �/�( Zip 1 e'j
Contractor Name License #
Address City Zip Phone_
Architect/Engineer License #_
Address City Zip _ Phone
p-c pry l s K i ja7T-ruC,, &v-rm,zs; Po
TYPE OF PROJECT� O ( � l�� (��(: � �- 1�� I �
4 F21
Sewage Disposal Right-of-Way Width Culvert Permit No.
LOCATIONAL INFORMATION: SEC TWP RGE 16th
Plat Name/Short Plat No. Segregation No. J
Lot/Parcel # 7 �- J Block # Lot Sze / 0� ` x �0 G
Is the average slope of the property in excess of 25%? Yes No Has construction started? Yes No
This structure will be used for the following purpose
Other buildings on this property /
1', Alr 1/. p
WNER/AGENT SIGNATURE / / DATE
4
NOTICE: Front Yard Setbacks. Curbs, Sidewalk Edge, Edge of Street pavement is not necessarily your front property line. In the case
where your setback will be measured from the front property line, be certain that you are measuring from the actual front property line and
that your plot plan depicts this. In the event your setback will be measured from a private access easement,the edge of the improved road
is not necessarily your front property line. Be certain that you are measuring from the edge of the actual easement and that your plot plan
depicts this.
ACKNOWLEDGED
------------------------OFFICE USE ONLY BELOW THIS LINE------------------------
PERMIT CONDITIONS . . .
ZONING Max Lot Cover % Max Bldg. Height ft
SETBACKS:
Front
Side
Rear
Basic Plan # Other Covenants
SPECIAL CONDITIONS . . . rs B „E
L� v
JUL0�SANITATION PUBLIC WORKS
ON SITE LETTER DRAIN TRAFF
ENV HEALTH SEWER CN R/R _ RD IMP
OCD
_ ACCESS RSBP LS SLIDE CMBP
ESMT _ RSME STD BLA SLOPE CMME
ADDRESS PLBG SP SEPA SITE PLAN
CULVERT MBHM 5 ACRE OTHER FIRE
AFF/BOND MOVE LOTS OTHER
GRADING INSP 20 ACRE
OCP
— CU FL ZN FML BLA PLAT_ REZONE
SEPA SH LN SP VAR SU VA
PLUMBING PERMIT F31
MECHANICAL PERMIT (NOT � i MOBILE HOMES)
FIXTURES No. UNIT TYPE: F4�
Electric Oil___ Gas LPG Solar
Water Closets
Bath Tubs UNIT SIZE: BTU's KW
Shower Baths
Wash Basins _ No. FEE
Sinks FOR THE INST. OR RELOC. OF
Dish Washing Machine Forced Air Systems
Hot Water Tanks Fuel Storage Tanks
Drains Heat Pumps
Laundry Washers Wood Stove
Laundry Trays Fireplace Insert
Urinals —0— Clearance Fireplace
Drinking Fountains
Rain Leaders
Sumps
Vacuum Breakers
Gas Piping _ Permit Fee
Side Sewers
Water Service Line Total Due $
Misc
Total Fixtures GRADING/FILL INFORMATION a
Permit Fee No. of cubic yards:
Total Due $ To be removed from site
Related Bldg. Permit # To be imported to site
IF MORE THAN ONE BUILDING, SUBMIT SEPARATE APPLICATION FOR EACH STRUCTURE. A SEPARATE BUILDING
PERMIT MUST BE ISSUED FOR EACH BUILDING. 76
BUILDING DIMENSIONS:
MAIN FLOOR MAIN FLOOR SQ. FT.
SECOND FLOOR SECOND FLOOR SQ. FT.
THIRD FLOOR THIRD FLOOR SQ. FT.
FOURTH FLOOR FOURTH FLOOR SQ. FT.
MEZZANINE MEZZANINE SQ. FT.
BASEMENT BASEMENT SQ. FT.
GARAGE GARAGE SQ. FT.
CARPORT _ CARPORT SQ. FT.
DECK DECK SQ. FT.
NUMBER OF FIREPLACES TOTAL SQ. FT.
FOR OFFICE_ USE ONLY '
ROUTING SCHEDULE: 4)52
'
)
Bldg: sent rcv'd � Valuation � C•
Site Plan: sent rcv'd '-Plan CV6—c'k rcp #
San: sent rcv'd Permit Fee
Env. Hlth: sent rcv'd Penalty Fee
Eng: sent _ rcv'd Plumbing Fee
FM: sent rcv'd Mechanical Fee
Env. Cklt Fee
TOTAL DUE: