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Home My WebLink About3719 168th St Ne_BLD6225_2025 i Permit Packet Coversheet Community and Economic Development City of Arlington • 18204 591h Avenue NE • Arlington,WA 98223 • Phone (360)403-3551 Permit Number: BLD6225 Permit Type: Commercial Plumbing Address/Parcel: 3719 168th St Ne Completed (Month/Year): Withdrawn December 2024 Land Use ❑ Notice of Decision ❑ Bonding or Assignment of Funds ❑ Staff Report o Confidential Documents. Contact the ❑ Application City to obtain. ❑ Narrative ❑ Letters and Project Documents ❑ Legal Description ❑ Other: ❑ Vicinity Map ❑ Site Plan Civil ❑ Landscape Plan ❑ Issued Permit ❑ Complete Streets Checklist ❑ Application ❑ Traffic Impact Analysis ❑ Other Applications ❑ Snohomish County Traffic Mitigation Offer ❑ Construction Calculation Worksheet ❑ WSDOT Traffic Offer Form ❑ Approved Plans ❑ Tree Survey ❑ Review Comment Form ❑ Stormwater Drainage Report ❑ Letters and Project Documents ❑ Geotech Report ❑ Other Agency Permits ❑ Critical Area Evaluation Form ❑ Reports: ❑ SEPA Checklist o Drainage Report Pg: ❑ Public Notice Material o Stormwater Pg: ❑ Noticing and Related Documents o Geotech Pg: ❑ Water/Sewer Availability Certificate o All Other Reports ❑ Unanticipated Discovery Plan Form ❑ SEPA and Noticing Materials ❑ Aerial Photo of Site ❑ Inspections ❑ Proposed Building Materials ❑ As-Builts ❑ Lighting Plans and Lighting Cut Sheets ❑ Other: ❑ Color Elevations ❑ Design Matrix Building ❑ Plat Map ❑ Issued Permit ❑ Title Report El Application ❑ Lot Closures ❑ Additional Applications ❑ Preliminary Civil Plans ❑ Approved Plans ❑ Archaeological Survey ❑ Site Plan o Confidential Documents. Contact the ❑ Letters and Project Documents City to obtain. ❑ Calculations ❑ Topography(Existing Conditions) ❑ Project Specification Manuals ❑ CC&R's ❑ Reports ❑ Deeds/Easements/Conveyances ❑ Certificate of Occupancy /Dedications ❑ Inspections ❑ Developer's Agreement 0 Other: Drawings,Notes about withdrawal ❑ Recorded Copies Page 1 of 1 • = COMMERCIAL PLUMBING APPLICATION Community&Economic Development City of Arlington• 18204 59th Ave NE•Arlington,WA 98223 •Phone(360)403-3551 WHEN is a PLUMBING PERMIT REQUIRED? The City of Arlington requires a plumbing permit before a plumbing system or fixture is installed, altered, or remodeled. This includes commercial, tenant improvements, multi-family buildings, roof drains, and overflows, medical gas systems, commercial kitchens, grease traps and interceptors, sumps and cross connection backflow devices. The City of Arlington does not require a permit to stop leaks or clear stoppages,unless the piping is repaired,altered or replaced. SUBMIT THE FOLLOWING ELECTRONICALLY: ❑ Plumbing plans or drawings. (Minimum plan size is 18"X 24"scale,1/a"scale for details.) ❑ Fixture specifications and equipment(cut sheets)with locations. ❑ Location and type of all backflow assemblies for each fixture. IN ADDITION TO ABOVE,SUBMIT THE FOLLOWING,IF APPLICABLE TO YOUR PROJECT: ❑ Calculations for Grease Interceptor. ❑ Pipe size and location of sanitary and potable water systems. ❑ Riser diagram of waste,vent,and rain water systems,including sizes. ❑ Medical gas piping riser diagram,type of gas,storage room and size of piping. Type of Permit: ❑ New Installation [�� Addition/Alteration/Repair ❑ Industrial Property Address: 3 S ty E Project Valuation: Lot#: Parcel ID No.: Preferred Contact: O Owner gKontractor Project Description: !!e_ �QCatV1UVN 4Oi �o` 460k-►r ayA SILALV ►' l i r q 1/CJO rn Owner Name: %J 10 "C- �''`\\ y S Office No.: Email Address: Cell No.: 560 57 69 0 Mailing Address: }�q �$��! C "City: M.IK4 State: ! ,/ Zip: Contractor Name: )UO%�V� C10JOS '�Eel Office No.: �oV" Email Address: :)e C(()Siqp(joMS (,V�CIA NO(KV��o9�.�w�aiC 11 No.: S OS 9 Z Mailing Address: 4Qt Lr-he► St w City: rr1ir k-V VI d) State: LU P1 — Zip: 6Q L&I Contractor License Number: C , ACJV LQ 7 CO $ Expiration Date: 17 11 REV1.2020 Page 1 of 3 PLUMBING PERMIT FEES(per fixture) Commercial plumbing permits are required to submit line drawings.A plan review fee of 65%per Table 4-6 for plumbing permits will be assessed at time of submittal.Includes two(2)inspections with permit. Type of Fixture No.of Fixtures Cost per Fixture Subtotal Additional Plan Review fees x $ 75.00 = Alteration/repair piping x $ 15.00 = Backflow Assembly x $25.00 = Base Plumbing Fee $25.00 $25.00 Bath Shower Combo x $ 15.00 = Building Main Waste x $25.00 = Clothes Washer x $ 15.00 = Dishwasher x $ 15.00 = Drinking Fountain x $ 15.00 = Floor Drains x $ 15.00 = Grease Interceptor x $ 75.00 = Grease Trap x $25.00 = Hose Bibb x $ 15.00 = Icemaker Refri erator x $ 15.00 = Irrigation-per meter x $25.00 = Kitchen Sink&Disposal x $ 15.00 = Laundry Tray x $ 15.00 = Lavatory x $ 15.00 = Medical Gas Pi in <- 5 Inlets Outlets x $60.00 = Medical Gas Piping for each additional Inlet x $ 5.00 = Outlet > 5 Miscellaneous-regulated by plumbing x $ 15.00 = code not otherwise specified) Pretreatment Interce for x $ 15.00 = Re-inspection Fee all x $ 75.00 = Roof Drains x $ 15.00 = Shower(only) x $ 15.00 = Sink bar,service,etc. x $ 15.00 = Toilets x $ 15.00 = Urinal x $ 15.00 = Vacuum Breakers x $ 25.00 = Water Heater x $25.00 = Water Heater-Tankless x $ 25.00 = Permit Fee Table 4-6; Plan Review Fee Processing/Technology Fee $25.00 Total REV2.2024 Page 2 of 3 PROPOSED BUILDING USE ❑ New ❑ Restaurant ❑ Automotive Based Addition/Alteration ❑ Office ❑ Machine Shop ❑ Industrial ❑ Medical ❑ Other: CROSS CONNECTION Please check all appliances that are proposed or permanently connected to the water supply. ❑ Ice Machine ❑ Dialysis Equip. ❑ Air washers ❑ Coffee Urn/Espresso ❑ Hydrotherapy Equip. ❑ Steam Generators ❑ Carbonated Bev. ❑ Dental Equip. ❑ Dye Vats ❑ Fume Hoods ❑ Laboratory Equip. ❑ Pressure Washers ❑ Degreasers ❑ Autoclave/Sterilizers ❑ Cooling Towers ❑ Hot Tub/Spa ❑ Decorative Fountain ❑ Fire Sprinkler ❑ Aquarium ❑ Swimming Pools ❑ Sprinkler w/chemicals ❑ Lawn Irrigation ❑ Well on property ❑ Other: WASTEWATER DISCHARGE Does the plumbing system currently have a grease ❑ Yes No ❑ Don't Know interceptor? Does the plumbing system currently have an oil/water ❑ Yes ❑ No ❑ Don't Know separator? Is water used in the business process (washing,rinsing, ❑ Yes ❑ No ❑ Don't Know cooling)? Does your business require a NPDES permit? ❑ Yes ❑ No ❑ Don't Know I hereby certify that the above information is correct and that the construction on,and the occupancy and the use of the above-described roperty will be in accordance with the laws,rules and regulation of the State of Washington. ,lwle I z nature Print Name Date FOR STAFF USE ONLY PERMIT# ACCEPTED BY: DATE STAMP REV2.2024 Page 3 of 3 e ek k�V\ Z4'-'J `s Z`W J CX G � Permit#: 6225 Permit Date: 11/06/24 Permit Type: COMM HZCIAL PLUMBING Project Nam e Edward Jones Applicant Nam a Juan Carlos Rosas Applicant Address: 403 Lebor St Ne Applicant, City, State, Zip: Orting,Wa 98360 Contact: Juan Carlos Rosas Phone: 2539850592 Em al: exclusiveconstruction.painting@gm al.com Scope of Work: relocation of toilet, water heater and sink for bigger bathroom Valuation: 2500.00 Square Feet: 0 Num ber of Stories: 0 Construction Type: O xupancy G ioup: ID Code: Permit Issued: Permit Expires: 04/04/2025 Form Permit Type: COMM aCIAL PLUMBING Status: VOID/WITHDRAWN Assigned To: Hannah Hardwick Property Parcel# Address L egal Description O wner Nam e Cvner Phone Zoning 31052800203100 3 719 168TH ST NE HUITGER 250 BUSINESS/ RONALD PROFESSIONAL Contractors Contractor P rim ay Contact P hone A ddress C ontractor Type L icense License# Juan Carlos CONSTRUCTION Construction Juan Carlos Rosas Rosas 2539850592 4 03 Lebor St Ne CONTRACTOR Contractor EXCLUCP787Q8 Fees Fee D escription N otes A m cunt Processing/Technology $25.00 Non-perm ited Work V iolation $ 500.00 Pipe Alteration or Repair $15.00 Plum ling Base P erm i Fee $ 25.00 Sink(bar,service,etc.) $15.00 Toilets $15.00 Water Heater(Tank) $25.00 Plum ling Comm acial Plan Review T able 4-1 $73.49 Total $693.49 Notes Date Note C reated By: 12/20/2024 Applicant is voided.There is a new perm t application for this work by a contractor with a Hannah Hardwick plum ling license.New perm i num ter is 6275. Contractor does not have a plum hng license.Advised that contractor needs to have a plum hng 11/06/2024 license to apply for a plum ling perm t.Contractor also needs to apply for a city endorsem ait on Hannah Hardwick their UBI 11/06/2024 Per Kevin,this work has already been corn Oeted.Fee for work without a perm 1 will be added H annah Hardwick Uploaded Files Date File Nam e 11/06/2024 23096909-20241106 BLD6225 Drawing,pdf 11/06/2024 23096910-20241106 BLD6225 Application.pdf