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HomeMy WebLinkAbout321 CLARA ST_066997_2026 INSPECTION REPORT ii l, _ f N -(4ci -7. Lot #: Address: 32-1 Aj LZzContractor:O Owner: ODate: it -17-p NJ 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. Inspector: �— Date: //-/7-40 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 tz-Ad Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: INSPECTION REPORT ¢tiZN C.TO Permit No.: e& t0 591 Lot#: Address: 3 z-i /'j c-4. ,� z Contractor: O Owner: ma`s IN�� Date: 10 _ZY—oG, ❑ 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. 14517 4-' s,-2v-Ur T/P Q-J c.r7�-� 10 e�,.1 L'nz•ter-• . c 1J S u l.e 10c7t- .31�.�C - fins aZ � --tea s59 4z�Z Inspector: - — Date. z�P-off 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 OiC Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: INSPECTION REPORT -) ZN G 4S. 1,0 Permit No.: a& to 99 7 Lot#: 4" Address: 3 2-1 /ILI c44-►Z� + Contractor: �s Owner: I N Date: IR - ram-aG 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. Inspector: �� -� � Date: 8-�y TYPE OF INSPECTION REQUESTED ❑ Under-floor Cl Framing ❑ Gas Piping ❑ Footing W Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: -4NSPECTION REPORT 4titN G?'O Permit No.: ©to 997 Lot#: Q Address: 2- I iu C L-d� Contractor: L/+n� --z ° 9s, ,SO Owner: IN Date: E� -f U 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. Cl CALL 435-0674 FOR RE-INSPECTION - 24 hour notice required. u �5q z&IZ Inspector: Date: (9 '/-0-0�' 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: 3+`F INSPECTION REPORT V- 4yjN G TO Permit No.: -D 6 (.947 Lot#: F' Address: 3 21 �-• — Contractor: z.- 93, ,SO Owner: '4I N G Date: — 0 ce ;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. Inspector: Date: -9--a(Q TYPE OF INSPECTION REQUESTED ❑ Under-floor A 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 N G r Permit No.: 0 4 6 It 9 1 Lot#: 4 . Q' Address: 3 Z� Contractor: LAr-lLj o,� qs, ,SO Owner: SING Date: 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. Inspector: Date: t3-99-04, TYPE OF INSPECTION REQUESTED ❑ Under-floor ❑ Framing ❑ Gas Piping ❑ Footing ❑ Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove A-Z Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: PY\ INSPECTION REPORT ell,y1N G?'0 Permit No.: � 6 V7 Lot #: Address: ' ' Contractor: �s ,SO Owner: IN C' Date: ❑ APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION C( 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. G✓a 5 tires 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 .4 Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other:. �` INSPECTION REPORT 36& N G?'� Permit No.: CSC 6997 Lot#: Q' Address: 73 z i .v c.«TE44- Contractor: LA-K-so.-i 9S, ,t0 Owner: h,I N GDate: *7- 249—oco ;APPROVAL El 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: -a te Date: 7 A-8--o(- TYPE OF INSPECTION REQUESTED ❑ Under-floor ❑ Framing ❑ Gas Piping ❑ Footing ❑ Drywall, Nailing ❑ Consultation ❑ Foundation g Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: 3� INSPECTION REPORT IN G TO Permit No.: v 4? `gg-7 Lot #: Address: Contractor: 4- s c�j 9S O Owner: k4rt,c.'AtI N G� Date: ,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. rim Inspector: — Date: 77—18—OG 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: INSPECTION REPORT 1O4ti1N G To Permit No.: Lot #: Q' Address: (� Z Contractor: ��, �O Owner: SIN Date: X,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. j a cr N iD &A c r'J" P 0,r 2. Ar Inspector: �`l-- 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: City 01 :1t 1,1\G,r 11\ .� NOTICE and Inspection Report 1 Address Contractor Owner Requested by TYPE OF INSPECTION REQUESTED ❑ BLDG: Pmt. No. ❑ MECH: Pmt. No. ❑ PLBG: Pmt. No. ,Footing ❑ Framing ❑ Foundation ❑ Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough-In ❑ Fireplace and Chimney ❑ Furnace ❑ Other APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ APPROVED FOR OCCUPANCY subject to certificate of occupancy. ❑ Work listed below has been inspected and approved. ❑ Please contact inspector and arrange for appointment. ❑ Was not able to perform inspection. ❑ CALL 435-5785 FOR REINSPECTION —24 hour notice required. Inspector Date I was present during this inspection. 1 0i19 01 a ItIA1NGT11\ NOTICE and Inspection Report Address Contractor 1 Owner �� %spy✓ a II Requested by TYPE OF INSPECTION REQUESTED -BLDG: Pmt. No. ElMECH: Pmt. No. f f ❑ PLBG: Pmt.No. ❑ Footing ❑ Framing ❑ Foundation ❑ Drywall Nailing Final ❑ Concrete Slab ❑ Rough-In ElFireplace and Chimney ElFurnace ❑ Other CYAPPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ APPROVED FOR OCCUPANCY subject to certificate of occupancy. ❑ Work listed below has been inspected and approved. ❑ Please contact inspector and arrange for appointment. ❑ Was not able to perform inspection. ❑ CALL 435-5785 FOR REINSPECTION —24 hour notice required. Inspector Date I was present during this inspection- City of !---.,, lington NOTICE and Inspection Report Permit No. �� Legal Date Called ����1J Address a�.I Time Called Contractor/Ownne� ,/ By A Requested by C� TYPE OF • REQUESTED ❑ Setback ❑ Roof Diaphragm ❑ Insulation ❑ Plumb GW ❑ Framing Gas Piping ❑ Footing ❑ Drywall Nailing ❑ Final ❑ Foundation ❑ Roughin Plumbing ❑ Reinspection ❑ Shear Wall ❑ Mechanical ❑ Other -APPROVAL ❑ CORRECTION REQUIRED ❑ rrections listed below MUST BE MADE before work can be approved. ork listed below has been inspected and approved. ❑ CALL 435-0724 FOR REINSPECTION—24 hour tice required. Inspector Date ! � � .ram,` � `� C I T-'1rF t3F RL I r-4GTC)M CQIVSTRUCT I C]hl BERM I T PE FRM I -F IVO _ IbE, --6 C3 13 -7 Ovner: HAGENSTONI, MARC 321 N CLARA S`i' ARLINGTON 98223 Value of Work: S32, 000. 00 Tax ID: 006189-000-008-00 Phone: 360 435-2069 Describe Work: 308 KITCHEN ADDITION[ Proposed Use: KITCHENI Legal Description: Job Address: 321 N CLARA ST ARLINIGTON Contractor's Name Type Address License* MIKE LARSON 1 514 HIGHLAND DR MIKELC*099LE FRANK LONG PLB PO BOX 1476 LONG*FR024NS P E R N I T F E E S Equipment and Fixtures Number Fee Total Charge --- - - - - ----`-- - --- ----- ----- - --- PLUMBING FIXTURES 10= 00 .-- - FURNACE/UNIT HEATER 1 $15. 00 $15. 00 -YENITILATIONi FANS 1 57. 00 $7. 00 METAL FIREPLACE & CHIMNIEY 1 $11. 00 $11. 00 GAS PIPINIG 1-5 OUTLETS 1 $6. 00 -,!:6. 00 S U B T O T A L. . . . _ - r59. 0O TOTALS Fee Equipment $39. 00 Fixture $20. 00 Mech Permit -S;24. 00 Permit Fee $531. 20 Plan Fee $345. 28 Plumb Permit $25. 00 State fee $4. 50 SIGNATURE: TOTAL FEE. . . . . . . . . . . . . . . . . $988. 98 I HEREBY CERTIFY THAT I HAVE READ AND -};AMIMED THIS APPLICATIONI AMD $0. 00 KNO E SAME TO BE TRUE AMID COR- REC A L PROVISIO - O LAWS AND TOTAL DUE. - - - - - - - - - - - - - - - - $988. 98 ORD NIA CES OVE G I5 TYPE OF WOR W LL B EE3, ITH WHETHER SP IF EZCH I O DATE RECEIPT # V HU I, G OFF I L -lot I 4�`�Y °� RESIC __.,ATIAL ADDITION.,LTERATION 7 o PERMIT APPLICATION LrNG� Department of Community Development City of Arlington • 238 N Olympic Ave. •Arlington, WA 98223 • Phone (360)403 3431 • FAX(360)403 3447 THIS APPLICATION TO BE USED FOR ONE AND TWO DWELLING UNITS RESIDENTIAL STRUCTURES. THIS APPLICATION MUST BE ACCOMPANIED BY TWO(2) SETS OF CONSTRUCTION DRAWINGS, SIX(6)ACCURATE, FULLY DIMENSIONED PLOT PLANS AND TWO(2) SETS OF ENERGY CODE APPLICATIONS. TYPE OF PERMIT: Residential Addition ( ) Residential Alteration �IL n; Plumbing—� 514e ( ) Mechanical Project Address: '32 I\1 . C``G``��t s+' • • I v1�f O►il parcel ID#: Lot#: Subdivision: Project Description: Z_...-t I tM o Ck e- cider fi Ltd Owner: M ' Vq-yy�v 4 0 A I ,,l S-'Or Phone Number: (iz-kotp,),4 Address: -`>Z( r0- C'_I w� St-d City: N v1 State: b4 Zip Code:6i& /� a�3 II,, u Contact Person: l /i K�e La rscn, Phone Number: 3&0 (635 Z coo F Cell Phone: L(2 5-�57 �'7 4 Z Fax: E-mail: Address: City: AA State: Zip Code: Building Area (Sq Ft): 15c Floor: �� 2"d Floor: /G/ 3rd floor: Ar Deck: Alit Garage/Carport: A(A Basement: IV4 Project Valuation: Contractor: f+ 1%. ( AI C-AAA Phone Number: Ss v S 43 ?O[off( Address: 5/It 1, ni _ City:4 f t• State: �`— Zip Code: Contractor's License Number: t L -E 061 L EExp)rat ion:(p�J -��0 g Plumbing Contractor. 4p S /�+ Phone I�Vum"b�: L2 /Q 60131 Address: City: State: Zip Code: Contractor's License Number: Expiration: Mechanical Contractor: Phone Number: Address: City: State: Zip Code: Contractor's License Number: Expiration: I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the above- desibed pr�erty will be in accordance with the laws, rules and regulation of the State of Washington. Applicants Signature Date Ant Applicants Name s � FOR STAFF USE ONLY !s•Jm m`• L/ lV � J �L1J ermit# Accep ed By Amount Received Receipt# Date Received WEB Forms—39 age 1 of 1 5/05 dwa WASHINGTON SPOKANE DISTRIBUTION SALEM DISTRIBUTION CENTER 3307 Cedar Street CENTEI 1452 McDonald ST. NE Everett,WA 98201-4517 2721 Van Marte",ste. 5 Salem, OR 97303 425-259-6000 or 745-6000 Spokane,WA 99206 503-391-6000 82-5403 U.S.A. 800-666-6065 257 aitenC. 1 FAX:425-258-6734A 1 FAX: 09-921-137 1 FAX:503-1391-974 Skylites • Sunrooms • Railings -` DikAW .i `fJ SC-Al-G — 70 7 I 5 SAO? 5.> I 6'8' f I }- 22'--T-{ I �-- ILA' I J I i I MAI i �1 IME w EXLS 7'1),-- i-o u SE gsr�ws - �pp P02� I I 30. 7s--- - C I ST ��0� .�, o� �, �� ��� CITY OF ARLINGTON CONSTRUCTION PERMIT No 1640 ❑ COMBINATION ❑ BUILDING 10 MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO_. OWNER MAIL ADDRESS CITY ZIP PHONE Terry Allen 321 N. Clara Arlington, WA 98223 ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LIC NSE R MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE Y Home Town Heating 609 State Ave Marysville 98270 659-6901 HOMETH075Q2 PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE CLASS OF WORK ❑NLW ❑ADDITION ®ALTERATION ❑REPAIR ❑DEMOLI(ION ❑BUILDING RELOCATION VALUATION OF WORK s 450.0. 00. DESCRIBE WORK PROPOSE D USE OF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- LLGAL DESCRIPTION OF PROPERTY(SHOWN BELOW OR ATTACH FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK 1-0 1 BLOCK OF WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUMETO GIVE AUTHORITYTO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OFTHE PERFORMANCE OF TAX ID NUMBER I� CONSTRUCTION. PERMIT EXPIRES I YEAR FROM DATE OF ISSUANCE. 618 9—0 0 0—0 0 8 '0 0 0 2 (.15 615 0 61 SI&- REF CONTRACIO R AUTHORIZED AGENT DATE 1O8 ADORE SS 321 North Clara �— (OFFICE USE ONLY) MECHANICAL PLUMBING NO. TYPE OF FIXTURE FEE NO, TYPE OF EQUIPMENT FEE WATER CLOSEI (TOILLI) AIR COND.UNITS —H P EA BAIHIUB REFRIGERATION UNITS — H P EA. LAVATORY (WASH BASIN) BOILERS - H.P. EA SHOWLR GAS FIRED A C. UNITS — TONNAGE EA_ FORCED AIR SYSTEMS — B T U MEA 11. 00 KI ICHLN SINK & DISP. WALL HEATERS— B,T U M DISHWASHER LAUNDRY TRAY UNII HEATERS — B.TU M CLOIHESWASHLR EVAPORAI IVE COOLERS WAI ER HEATER 1 CLOTHES DRYERS 50 URINAL VENTILATICN FAN RANGE HOOD COMMERCIAL DRINKING FOUN I AIN FLOOR DRAIN AIR HANDLING UNIT— CPM VACUUM BREAKERS STOVE ;0 ROOF DRAINS - RAINLEADERS METAL FIREPLACE &CHIMNEY SINK (SERVICE - BAR, ETC.) WATER HEATER 0 GAS PIPING 0 SUBTOTAL S SUBTOTAL S 33 50 PERMIT S PERMIT S 15 00 TOTAL FEE S TOTAL FEE $ 48 50 PLAN CHECK FEE SIDE YARD SEIBACK FSTREL1SETBACK REAR YARD SETBACK DATE RECEIVED FEE RECEIPT NO USF /ONE AREA VACANT SITE — FEES VALUATION FEE YES ❑NO TYPE OF CONS1 OCCUPANCY GROUP NO OF DWELLING UNITS PLAN CHECKING NG BU'LDING $ SIZE Of BLDG. NO.OF STORIES MAX.00CLOAD PLUMBING FIRE SPRINKLERS REQUIRED 4 50 ❑YES NO MECHANICAL STATE BLDG.CODE COMMENTS ENERGY CODE SURCHARGE U.B.C. PENALTY SEC.303(a) WATER/SEWER FEES PAID TOTAL 1 Q 1(1(1C PER, VA ATION • J �.+ 1JJ WHENPROE Y ALID:ITEO 'NSl:U5SPA IT IS YOURPERN IPT PAID C - BY DATE cc: ASSESSOR,APPLICANT,TREASURER, BLDG, DEPT. eU1ER ORDS COPY City q A It L I N G T O N PERMIT AP (CATION 230 N. OLYMPIC AVE., ARLINGTON, V 6223 (206)435.5785 COMMERCIAL, RESIDENTIAL, MECHANICAL, PLUMBING, GRADING Tax Account Number 1i7/ / Job Site Address �caC '._..�_ t ck—' City Applicant Name /e-rry �. A L��r� n / Phone Mailing Address ,2J C/4 VC, S� City {�^(i y1 Zip 8� Z Contractor Name �EL1= License # Address . sc� City Zip Phone Architect/Engineer License # Address S-L n„p City Zip Phone TYPE OF PROJECT 21 Sewage Disposal ,/W'�Ri ht-of-Way Width Culvert Permit No. LOCATIONAL INFORMATION: SEC TWP RGE 16th Plat Name/Short Plat No./Segregation No. Lot/Parcel # ) t6� Block # 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 107 Other buildings on this property i 1 .ze Q:': LC.0 !�'� �� OWNER/AGENT SIGNATURE DATE 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:' / 1()n Max Lot Cover �f /n % Max Bldg. Height ft SETBACKS: `�j'1• I Front01— Side r C3fG� ' r .''�.,_Rear 1 I Basic Plan # Other Covenants SPECIAL CONDITIONS . . . 2 @ D L5 FEB " 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 Y MOVE LOTS OTHER _ GRADING INSP 20 ACRE OCP _ CU. FL ZN FML BLA PLAT_ _ _ REZONE_ SEPA SH LN SP VAR SU, VA - 1 ., I NG PERMIT ��—� MECHANICAL PERMIT (NOT rOR MOBILE HOMES) (� v, u u flYtURES No. UNIT TYPE: 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 F5-1 Permit Fee No. of cubic yards: Total Due $ To be removed from site Related Bldg Permit # To be imported to s to _ IF MORE THAN ONE BUILDING, SUBMIT SEPARATE APPLICATION FOR EACH STRUCTURE. A SEPARATE BUILDING PERMIT MUST BE ISSUED FOR EACH BUILDING. F6_1 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: Bldg: sent rcv'd Va uation Ll oo (� Site Plan sent _ rcv'd "Plan Clieck rcp # San: sent rcv'd V 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: INSPECTION REPORT N ¢1.1 G?'� Permit No.: o(o Lot #. Q Address: 3 z-i &1 L �. Z Contractor: �O Owner: SING Date: it-1 7—o c> A 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. Inspector: w xzx — 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 tz-J ?Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: iZ.579 INSPECTION REPORT ii ?' Permit No.: Q& & 9`11 Lot#: Address: 3 L-t /-I,Contractor:O Owner: C' Date: /� ❑ APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION CORRECTION REQUESTED di(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. S: f z-L ti l ilt.�IT? d A) nS IOL�L .3;lit.L N Az. �-a.� =zT.t�•J Inspector: �z-��t— 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 Ck Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: INSPECTION REPORT IN G ¢1. ?'o Permit No.: v& (a 94 � Lot#: Q" Address: 3 Zrl /cr ZAA_&Ln� Contractor: L.,a-2s o x.l O Owner: �s1qIN�� Date: 9- f�.-aC. 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. Inspector: Date: TYPE OF INSPECTION REQUESTED ❑ Under-floor ❑ Framing ❑ Gas Piping ❑ Footing JZ Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: -INSPECTION REPORT 4ti1N G TD Permit No.: o le 407 Lot #: Address: 3 Z I N C L-t17L4 z Contractor: 4i+7c-r i� O Owner: 9s�jNG� Date: 8 --iv-v 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. 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 Orinsulation ❑ Other: 3�`F INSPECTION REPORT IN G 4ti 1'G Permit No.: a G (.947 Lot#: Q Address: 3 Z-r Contractor: O Owner: ma`s IN C'� Date: 3-9 ;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. Inspector: Date: 9 -9 0 e 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: INSPECTION REPORT CC.);i Permit No.: o 46 4 9 7 Lot#: Address:Contractor:O Owner: Date: 8— 8 -o E( 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. ,J Inspector: Date: t3--6—OG TYPE OF INSPECTION REQUESTED ❑ Under-floor ❑ Framing ❑ Gas Piping ❑ Footing ❑ Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove 2:6 Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: INSPECTION REPORT %A-pi 4ti1N G r0 Permit No.: &'`��Lot#: Q' Address: � 4 6A; ?� Contractor: O Owner: 111 N�� Date: ❑ APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION G( 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. �lc.✓ c-f e CCC c IS,c �s sz 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 4 Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: INSPECTION REPORT 36& PIV 4yjN G I'O Permit No.: 0 C 6997 Lot#: Address: 3 z i f4_1 etO-9.44- Contractor: LAx-sow 9s GO Owner: �� a s n j N Date: '7-- zfg—oco 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. s 7iQ- r— 10T 106 0 00,Y_') Inspector: ,!!!5 Date: 7• 9--OC TYPE OF INSPECTION REQUESTED ❑ Under-floor ❑ Framing ❑ Gas Piping ❑ Footing ❑ Drywall, Nailing ❑ Consultation ❑ Foundation JXShear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: 328 INSPECTION REPORT ¢1.1N Gro Permit No.: o6, L99-► Lot #: `Z Address: 3'Zi I%z Gi- 1-r�ar1 Contractor: LA-rLso O Owner: Fr✓srt) j 9s�ING� Date: ,,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. Inspector: ,°�L Date: 7 19-O(- TYPE OF INSPECTION REQUESTED f� 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 J 4ti1N G?'O Permit No.: Lot#: Address: (1 Z Contractor: /�� 9s OHO Owner. t rejK IN Date: 7 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. � 10 m e, '_-) '" o tj-0 2 pn!P � Inspector: < 'ZT-- Date: 7-1 0—O(o TYPE OF INSPECTION REQUESTED ❑ Under-floor ❑ Framing ❑ Gas Piping ❑ Footing ❑ Drywall, Nailing ❑ Consultation y ,Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: I I City of AiItLIN G,r41N NOTICE and Inspection Report Address Contractor Owner Requested by TYPE OF INSPECTION REQUESTED ❑ BLDG: Pmt. No. ❑ MECH: Pmt. No. ❑ PLBG: Pmt. No. jAFooting ❑ Framing ❑ Foundation ❑ Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough-In ❑ Fireplace and Chimney ❑ Furnace ❑ Other "Q.APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ APPROVED FOR OCCUPANCY subject to certificate of occupancy. ❑ Work listed below has been inspected and approved. ❑ Please contact inspector and arrange for appointment. ❑ Was not able to perform inspection. ❑ CALL 435-5786 FOR REINSPECTION —24 hour notice required. i Inspector Date I was present during this inspection. cagq .ZltUnCTNm J NOTICE and Inspection Report Address _�1 Contractor 7 Owner Requested by TYPE OF INSPECTION REQUESTED -BLDG: Pmt. No. ❑ MECH: Pmt. No. ❑ PLBG: Pmt. No. ❑❑ Framing g ❑ Foundation ❑ Drywall Nailing Final ❑ Concrete Slab ❑ Rough-In El Fireplace and Chimney El Furnace Other D APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ APPROVED FOR OCCUPANCY subject to certificate of occupancy. ❑ Work listed below has been inspected and approved. ❑ Please contact inspector and arrange for appointment. ❑ Was not able to perform inspection. ❑ CALL 435-5785 FOR REINSPECTION —24 hour notice required. Inspector Date I was present during this inspection. City of !_.'1 ington NOTICE and Inspection Report Permit No. /6 7 tL Legal Date Called _ —��l J Address Time Called Contractor/Own � Qn ' X Lei By (v_n Requested by-%, o ,- TYPE OF • REQUESTED ❑ Setback ❑ Roof Diaphragm ❑ Insulation ❑ Plumb GW ❑ Framing Gas Piping ❑ Footing ❑ Drywall Nailing \ ❑ Final ❑ Foundation ❑ Roughin Plumbing ❑ Reinspection ❑ Shear Wall ❑ Mechanical ❑ Other ,7*� PROVAL ❑ CORRECTION REQUIRED ❑ «ections listed below MUST BE MADE before work can be approved. ork listed below has been inspected and approved. ❑ CALL435-0724 FOR REINSPECTION—24 hour otice required. Inspector Date 11V lll�7,0 IVA- G I T--e CIF AR1— I IVGTC3t%4 GC3tVS-IF RIJCT I OtV PE RM I T FPERM I -F IVU _ Owner: HAGENSTO.N, MARC 321 N CLARA ET ARLINGTON 98223 Value of work: S32, 000. 00 Tax ID: 00GI89-000-008-00 Phone: 360 435-2069 Describe Work: 308 KITCHEN ADDITION Proposed Use: KITCHEN Legal Description: Job Address: 321 N CLARA ST ARLINGTON Contractor's Name Type Address License# MIKE LARSON 1 514 HIGHLAND DR MIKELC*099LE FRANK LONG PLB PO BOX 1476 LONG*FRO24NS P E R NI I T F E E S Equipment and Fixtures Number Fee Total Charge - ------ -- -- --- -- --- --- - - -• - ---- ---- -- -- - - -- - - -- PLUMBING FIXTURES 2 S10< iZ,�i 520< 00 FURNACEfUNIT HEATER 1 $15. 00 S15< 00 ) NTILATION FANS 1 $7. 00 METAL FIREPLACE & CHIMNEY 1 511. 00 $11. 00 GAS PIPING 1-5 OUTLETS 1 $6. 00 56. 00 5 U B T O T A L. . . . . . $59. 00 TOTALS Fee Equipment $39. 00 Fixture $20. 00 Mech Permit S24. 00 Permit Fee $531. 20 Plan Fee $ 34345. 28 ' Plumb Permit $25. 00 State tee $4. 50 SIGNATURE TOTAL FEE. . . . . . . . . . . . . . . . . $988. 98 I HEREBY CERTIFY THAT I HAVE READ AND - AMINED THIS APPLICATION AND PAYMENTS. . . . . . . . . . . . . . . . . . $0. 00 AKE TO BE TRUE AND COR- REC A L PROVISIO: O LAWS AND TOTAL DUE. . . . . . . . . . . . . . . . . $988. 98 ORD NA :-E5 OVE _ 15 TYPE OF WOR W LL B - E }' ITH WHETHER SP IF E- 14 I -' DATE RECEIPT &-k* OFF i L r,r 5l1-% jb1, G��`Y °� RESIL _NTIAL ADDITIOI LTERATION 7 o PERMIT APPLICATION -IN G� Department of Community Development City of Arlington • 238 N Olympic Ave. • Arlington, WA 98223 • Phone (360)403 3431 • FAX(360)403 3447 THIS APPLICATION TO BE USED FOR ONE AND TWO DWELLING UNITS RESIDENTIAL STRUCTURES. THIS APPLICATION MUST BE ACCOMPANIED BY TWO(2) SETS OF CONSTRUCTION DRAWINGS, SIX(6)ACCURATE, FULLY DIMENSIONED PLOT PLANS AND TWO(2) SETS OF ENERGY CODE APPLICATIONS. TYPE OF PERMIT: (�) Residential Addition ( ) Residential Alteration l S�n� Plumbing— OMechanical 61 �t.4�f _ Project Address: `3 Z 1 Iy . Ck 0"It si- ' ' i vet fI3V1 Parcel ID#: law `f� ��'`'�'O� Lot#: Subdivision: Project Description: t- -1 c d e- Owner: 4vv,.y 4 0 A i Ie L Sfor) Phone Number: d Address: :�)ZI f&- C'_I cv St- City: IA/%i r$T�v-� State: !� Zip Code:Gl Contact Person: �c k e 1 a r5� Phone Number: 3 w0 z 00F Cell Phone: y 2 5-s5-2 Z7 4 Z Fax: E-mail: Address: City: State: Zip Code: Building Area (Scl Ft): I't Floor: �,U� 2nd Floor: 3`d floor: Deck: zy// Garage/Carport: r�, A Basement: IV4 Project Valuation: Contractor: t i ,� 41; . �l(�1 SOA Phone Number: of io a 4�5 1?0&9 Address: City:--� _ State: Zip Code: Contractor's License Number: e - L Expiration-� / -�{7—O K Plumbing Contractor' o `�"'i i Phone Numbe -2Q p y3/ Address: City: State: Zip Code: Contractor's License Number: Expiration Mechanical Contractor: Phone Number.- Address: City: State: Zip Code: Contractor's License Number: Expiration: I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the above- des ed pro�erty will be in accordance with the laws, rules and regulation of the State of Washington T Applicants Signature Date Ant Applicants Name FOR STAFF USE ONLY Wii i \.oL ILK qq � -s�co ermit# Accepted By Amount Received Receipt# Date Received WEB Forms-39 age 1 of 1 5/05 dwa WASHINGTON SPOKANE DISTRIQl1TION SALEM DISTRIBUTION CENTER 3307 Cedar Street CENTEI 1452 McDonald ST. NE ,,-Everett,WA 98201-4517 2721 Van Marten ate. 5 Salem, OR 97303 or 745-6000 Spokane,WA 99206 503-391-6000 Z%t800-382-5403 a+IIt425-259-6000 enc. 1 FAX6425 258-6734A 1 FAX: 09-921-137 1 FAX65 3-1391-974 *0"e&" Skylites • Sunrooms • Railings 70 T 5' l � Swap 5s' bo --T--1 i 121D' I I _ I T f - - "DECK 3w� - I I I i i P i i Z8 ' 78 C I Y- S City q ARLINGTON PERMIT AP"'(CATION 230 N. OLYMPIC AVE.,ARLINGTON, V1-18223 (206) 435-5785 COMMERCIAL, RESIDENTIAL, MECHANICAL, PLUMBING, GRADING Tax Account Number Job Site Address , ;,ft.__J City �D Applicant Name / Phone3-5- Mailing Address ;3 al C14� S7 City �(j 22 Zip 8� Z Contractor Name SELF= License # Address Sra k-vip City Zip Phone Architect/Engineer -S Iz-lc License # Address City Zip Phone TYPE OF PROJECT a Sewage Disposal 1A, ht-of-Way Width Culvert Permit No. LOCATIONAL INFORMATION: SEC TWP RGE 16th Plat Name/Short Plat No./Segregation oo./Segregation N/o. ��) Lot/Parcel # �,n Block # l�y �i�C 1.1L� /_ oirL& 1 Is the average slope of the property in excess of 25%? Yeess; No Has construction started? Yes No �. This structure will be used for the following purpose Other buildings on this property i 1_it� OWNER/AGENT SIGNATURE DATE 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. ! Q % Max Bldg. Height ft SETBACKS: Front Side fir i c' i Rear Basic Plan # Other Covenants SPECIAL CONDITIONS . . . @ D ffB r 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 u 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 CITY OF ARLINGTON CONSTRUCTION PERMIT �jo _ f 64U ❑ COMBINATION ❑ BUILDING MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO. OWNER MAIL ADDRESS 01 Y ZIP PHONE Terry Allen 321 N. Clara Arlington, WA 98223 ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICIENSE M MECHANICAL CONTRACTOR �iAIL •ADDRFSS ;I', ZIP PHONE LICENSE# Home Town Heating 609 State Ave Marysville 98270 659-6901 HOMETH075Q2 PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE 0 CLASS OF WORK ❑NEW ❑ADDITION ®ALTERATION ❑REPAIR ❑DEMOLI TION ❑BUILDING RELOCATION VALUATION OF WORK s 4500. 00. DESCRIBE WORK PRUPOSE D USE OF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- LLUAL DESCRIPTION OF PROPERTY(SHOWN BELOW OR ATTACH FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK LOT-BLOCK-OF 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 TAX ID NUMBER LOCAL LAW REGULATING CONSTRUCTION OFTHE PERFORMANCE OF 6189-000-008-0002 (_1561506� CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE. SIG1 - RE OF CONTRACO R AUTHORIZED AGENT DATE rig a!:URI SS 321 North Clara (OFFICE USE ONLY) MECHANICAL PLUMBING NO TYPE OF FIXTURE FEE NO TYPE OF EQUIPMENT FEE WATER CLOSET (TOILET) AIR COND.UNITS —H P EA BAIHIUB REFRIGERATION UNITS — H P EA LAVATORY (WASH BASIN) BOILERS - H P. EA SHOWER GAS FIRED A C. UNITS —TONNAGE EA. KI ICHEN SINK & DISP FORCED AIR SYSTEMS— B T U MEA 0 DISHWASHER WALL HEATERS — B,T.0 M LAUNDRY TRAY UNIT HEATERS— B.T.0 M CLOIHES WASHER EVAPORATIVECOOLERS WA1LRHEATER 1 CLOT HESDRYERS 0 URINAL VENTILATICN FAN DRINKING FOUN I AIN RANGE HOOD COMMERCIAL FLOOR DRAIN AIR HANDLING UNIT— CPM VACUUM BREAKERS STOVE ROOF DRAINS RAINLEAUERS METAL FIREPLACE &CHIMNEY SINK (SERVICE - BAR,ETC.) WATER HEATER GAS PIPING O SUB TOTAL S SUBTOTAL $ 33 50 PERMIT $ PERMIT S 15 00 TOTAL FEE $ TOTAL FEE $ 48 50 SIDE YARD SE IBACK STRLLI SETBACK REAR YARD SETBACK DATE RECEIVED PLAN CHECK FEE FEE RECEIPT NO. USE/UNF LOT AREA VACANT SITE VALUATION FEE ❑YLS ❑NO FEES TYPE OF CONST OCCUPANCY GROUP NO OF DWELLING UNITS PLAN CHECKING VG BU'LDING ; SIZE OF BLDG NO OF STORILS MAX,OCC.LOAD PLUMBING FIRE SPRINKLERS REQUIRED ❑YES ❑ MECHANICAL 4 50 NO STATE BLDG.CODE COMMENTS ENERGY CODE SURCHARGE UBC. PENALTY SEC.303(a) WATER/SEWER FEES PAID TOTAL Q 1(1f� PERMITYA ATION C3 IJ J WHEN PRO E Y ALIDATED MJU&SPA ) T IS YOUR PE%%4I IPT PAID C BY BUIIDI � L DATE cc: ASSESSOR,APPLICANT,TREASURER, BLDG- DEPT R ORDS COPY