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HomeMy WebLinkAbout230 E Burke Ave_BLD193_2025 � �-:,� ? CITY OF ARLINGTON 238 N. OLYMPIC AVE - ARLINGTON, WA. 98223 PHONE; (360) 403-3551 BUILDING PERMIT Address:230 E Burke Ave Permit#: 193 Parcel#:00461801500100 Valuation: OWNER APPLICANT CONTRACTOR Name:ST ANDREW ORTHODOX CHURCH Name:Oso Plumbing Name:Oso Plumbing Address:PO BOX 3466 Address:23020 Oso Loop Rd Address:23020 Oso Loop Rd City,State Zip:ARLINGTON,WA 98223 City,State Zip:Arlington,WA 98223 City,State Zip:Arlington,WA 98223 Phone: Phone:360-435-3508 Phone:360-435-3508 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name:Oso Plumbing Address: Address:23020 Oso Loop Rd City,State,Zip: City,State,Zip:Arlington,WA 98223 Phone: Phone:360-435-3508 LIC#: EXP: LIC#:OSOPL**IOIOP EXP:9/11/2014 JOB DESCRIPTION PERMIT TYPE: Plumbing CODE YEAR: STORIES: CONST.TYPE: DWELLING UNITS: OCC GROUP: BUILDINGS: OCC LOAD: PERMIT APPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY;NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27, THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBC110/IRC110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of l' ton must be reported on your sales tax return fib and code City of Arl' gton#3101, ki 4"W Signal ' Print Name Date Released By ate CONDITIONS Install an RPBA as premise isolation after the meter. THIS PERMIT AUTHORIZS ONLY THE WORK NOTED,THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION. PERMIT FEES Date Description Fee Amount 9/27/2013 Plumbing Permit Fee(Enter Fixture Fee) $25.00 9/27/2013 Plumbing Permit Fee(Enter Fixture Fee) $144.00 Total Due: $169.00 Total Payment: $0.00 Balance Due: $169.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon " � J a Permit Information Date 9/20/2013 _ Permit Number 193 Project Name St.Andrew Orthodox Church Permit Type Plumbing Site Address 230 E Burke Ave Description Mechanical Valuation 14000.00 Square Feet 0 Status Applied Permit Issued Permit Expires Phone 360-435-3502 Email info@osoplumbing.com Occupancy Load Type of Construction Proposed Use Plumbing Alteration Number of Stories 0 Assigned To Amy Rusko Property Information Owner Information Parcel*00461801500100 ST ANDREW ORTHODOX CHURCH ST ANDREW ORTHODOX CHURCH PO BOX 3466 230 E BURKE AVE ARLINGTON,WA 98223 Contractors Contractor Name Primary Contact Phone Email Contractor Type License License# _ :[Oso Plumbing Kevin Burke 360-435-3508 info@osoplumbing.com CONTRACTOR OSOPL"101OP Review Date Type Description Target Date Completed Date Assigned To Status 9/20/2013 Commercial Plumbing Plumbing Review 9/27/2013 Chris Young In Review 9/20/2013 Commercial Plumbing Plumbing Review 9/27/2013 PW Admin Rev In Review 9/20/2013 Commercial Plumbing Plumbing Review 9/27/2013 PW-CCC-Rev In Review 9/20/2013 Commercial Plumbing Plumbing Review 9/27/2013 PW-Sew-Rev In Review 9/20/2013 Commercial Plumbing Plumbing Review 9/27/2013 PW-Wat-Rev In Review 9/20/2013 lCommercial Plumbing Permit Tracking 9/27/2013 Amy Rusko In Review Notes Date Note 9/20/2013 Restroom reconfiguration.No new cross connection or waste discharge. Email History Date Emailed To 9/20/2013 cyoung@adingtonwa.gov,kwallace@arlingtonwa.gov;Itaylor@arlingtonwa.gov,bbleke@arlingtonwa.gov; kdarke!Madingtorrwa.gov,PW CCC•Rev@arOngtonwa.gov,PW-Wat4%vCarlingtonwo.gov,PW-Sew-Rev@arlingtonwa.gov Uploaded Files Upload File I _ Date File i 9/20/2013 St Andrew Plans. df Delete 9/2=013 1 St Andrew Aoolication and SaecificajjgD .odf Delete COMMERCIAL PLUMBING PERMIT APPLICATION Department of Community Development City of Arlington • 238 N Olympic Ave. •Arlington, WA 98223 • Phone (360)403 3551 • FAX (360)403 3418 THIS APPLICATION MUST BE ACCOMPANIED BY THREE(3)SETS OF CONSTRUCTION DRAWINGS, AND THREE (3) SETS OF FIXTURE SPECIFICATIONS(CUT SHEETS). CALCULATIONS ARE REQUIRED FOR GREASE INTERCEPTOR/F APPLICABLE. Type of Permit: ® Commercial ED Commercial Addition/Alteration (❑) Industrial Project Address: .2 C 3 U A KL- Parcel ID#: Lot#: Subdivision: 141 Project Description Valuation Owner: /k/y n/L(?W C'�n''C4 G n o-r C WJ4'"r Phone Number: Address: 2-�6 C- 1'UfLK E ( City: State:S—L Zip Code: 9 YZ0 Contact Person: Phone Number: tl 3 3 Yu Cell Phone: 3 Coo (a-Nn.1 /3/3 Fax: E-mail ION -�o (P C,So c GSM Address: 7-3 G 2 c' oso 1-CJO47 R V City: .44 1 ►-1611" State: Zip Code:-2 YL I Please List quantity of fixtures Below: WATER CLOSET BATH TUB SHOWERS LAVATORIES CLOTHES WASHER LAUNDRY TUBS 7 FLOOR DRAINS FLOOR SINKS SINKS URINALS SUMPS DISHWASHERS WATER HEATERS ROOF DRAINS WATER PIPING DWV ALTER/REPAIR LAWN SPRINKLERS DRINKING FOUNTAINS MISC PLUMB FIXTURE GREASE INTERCEPTOR GREASE TRAP Contractor: 6 S[i c i u m 7� 1^-11 Phone Number: EGG _/(1) Address: 2 1 G o G t),C' "or 6-0 City: A&( State: Zip Code: OI PZz� Contractor's License Number: 0 PL 0 P Expiration: q- 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 regulation of the State of Washington. l� /� / -_� ?-IQ - i-) Applicants Signature Date c Print Applicants Name RECEIVED FOR STAFF USE ONLY S E P 2 0 2013 Permit# Accepted By Amount Received Receipt# -COAMERNMENTER Washington State Depaftlnerlt of ChLabor & Industries Contractors or Tradespeople Detail Return to List > Start a New Search > M Printer friendly Verify Workers' Comp Premium Status Check for Dept. of Revenue Account About General/Specialty Contractor A business registered as a construction contractor with L&I to perform construction work within the scope of its specialty.A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. Business and Licensing Information Name OSO PLUMBING UBI No. J) 601273492 Phone No. (360)43 5-3 508 Status � Active Address 23020 Oso Loop Rd License No. OSOPL**101 OP Suite/Apt. City Arlington License Type Construction Contractor State WA Effective Date 9/17/1990 Zip 98223 Expiration Date 9/11/2014 County Snohomish Suspend Date J) Business Type Individual Specialty 1 .b General Parent Company Specialty 2 lb Unused Business Owner Information L:�j Hide All Name Role Effective Date Expiration Date BURKE, KEVIN J Owner 01/01/1980 Bond Information lb Bond Bond Company Bond Account Effective Expiration Cancel Impaired Bond Received Name Number Date Date Date Date Amount Date 2 CBIC 628829 09/10/2001 Until $12,000.00 08/08/2001 Cancelled Assignment of Savings Information ID No records found for the previous 6 year period 9 Insurance Information i) Insurance Company Policy Effective Expiration Cancel Impaired Amount Received 1 Name Number Date Date Date Date Date 10 CBIC INS628829 09/10/2010 09/10/2014 $1,000,000.00 08/26/2013 TOTO® CST744SL Drake' Close Coupled Toilet, ADA, 1 .6GPF f FEATURES • G-Max®flushing system, low consumption (1.6GPF/6.OLPF) • Universal Height -_ • Two-piece design with high-profile tank • Elongated front bowl and tank set, less seat • Chrome trip lever • 12" Rough-in, less supply • ADA compliant MODELS • CST744SL Elongated bowl, 12" rough-in, less seat • CST744SLB* Same as above with bolt down lid (special order) • CST744SLD* Same as CST744SL with insulated tank(special order) • CST744SLDB* Same as CST744SL with bolt down lid & insulated tank(special order) • CST744SLR* Same as CST744SL with right hand trip lever(special order) COMPONENTS • C744EL- Elongated Front Bowl • ST743S-Tank and Cover only- Left-hand trip lever • ST743SR-Tank and Cover only-Right-hand trip lever • SS114 SoftClose®seat(sold separately) • SS204 SoftClose®seat(sold separately) IMMAX • SC534 Seat(sold separately) nUSHING•Tn•r n T•T•• • SC134 Seat(sold separately) COLORS/FINISHES CODES/STANDARDS • Standard • Meets and exceeds ASME Al12.19.2/CSA B45.1, #01 Cotton • Certifications: IAPMO(cUPC), State of #03 Bone Massachusetts , City of Los Angeles, and others #11 Colonial White Code compliance: UPC, IPC, NSPC, NPC Canada, #12 Sedona Beige and others #51 Ebony • ADA compliant(when installed with trip lever PRODUCT SPECIFICATION located on the approach side) The two-piece G-Max flushing system toilet shall be 1.6GPF/6.OLPF. Toilet shall be universal height and ADA compliant, Toilet shall have high-profile tank, ® c u Pc RECEIVED E® elongated front bowl and chrome trip lever. Toilet shall be TOTO Model CST744SL SEP 2 0 2013 COA PERMIT CENTER BILL l q'5 CST744SL Drake® Close Coupled Toilet, ADA, 1 .6GPF/6.0 GPF SPECIFICATIONS INSTALLATION NOTES • Water Use 1.6 GPF/6.OLPF Back-to-Back Toilet Installations: • Flush System G-Max TOTO recommends the use of a nationally listed, • Min. Water Pressure 8 psi (static) double sanitary tee-wye only, in vertical waste stacks, • Water Surface 10-3/8" x 8-1/4" in accordance with the stipulations noted in the • Trap Diameter 2-1/8" majority of nationally recognized plumbing codes. • Rough-in 12" • Trap Seal 2-3/8" • Warranty One Year Limited Warranty • Material Vitreous china • Shipping Weight C744EL- 56.5lbs ST743S - 35lbs • Shipping Dimensions C744EL 29-1/2"L x 16"W 1 D oub on e/t BondpDouble \anitary Tee/Sanitary Goss x 10-1/4"W2 x 18-1/4"H r NO ST743S 20-1/8"L x 8-1/4"W x 15-1/2"H &1/2" 14" (140mm ® (355Imm) —18-1/2"(470mm) (30mm 28"(710mm) 19-1�94m� C� } 11-T 30-1/2" 17-1l2" (775mm) (445mm) 1/2"Supply 16-1/2" f \• (420mm) 8"-(202mm 1 j r, N5MM, -//l 9-7/8" 250rtim) TOTO. 56MM These dimensions and specifications are subject to change without notice Ph:(888)295-8134 Fax:(800)699-4889 www.totousa.com I SS-00350 v.04 Printed in U.S.A.i©TOTO USA 06/09 1 Printed on recycled paper 0 r URINAL 1 VITREOUS CHINA 27-750 CLINTON TM (J Space Saver Siphon Jet/Top Spud Wall Hung Features: • Low Consumption 1.0 gpf (3.8 Lpf) • Minimum Wall Space • Dual Hangers • For Exposed Flushometer (top spud) 1" x 3/4" Inlet • 2" S.P.S. Female Outlet Connection Supplied • ADA Compliant Dimensions: Height.......................................21 3/4" Width...............................................14„ Depth........................................14 3/8„ Inlet................................................ 3/4" Outlet ............................................... 2„ Shipping Weight ................... 41 Ibs 14" - 2'2 13 " RECOMMENDED STATIC WATER 21'i41' PRESSURE FOR PLUMBING FIXTURES IS 20-80 PSI STATIC PER ANSI STANDARDS A112.19.2 APPENDIX B THIS FIXTURE QUALIFIES ACCORDING TO ASME TEST PROCEDURES AS A _ LOW CONSUMPTION URINAL WITH = 14V'—I AN AVERAGE CONSUMPTION PER FLUSH OF 1.0 gpf(3.8 Lpf)OR LESS. Job Name Date Model Specified quantity S UPC Customer Contractor ® www.gerberonline.com Architect/engineer Because we are committed to continual product improvement,specifications are subject to change without notice. 09/09 Royal® Model o Flushometero 0 Description Exposed Urinal Flushometer,for 3/4"top spud urinals. Flush Cycle ❑Model 186-1.0 Low Consumption(1.0 gpf/3.8 Lpf) • ,, , e ❑Model 186 Water Saver(1.5 gpf/5.7 Lpf) Specifications ` Quiet,Exposed,Diaphragm Type,Chrome Plated Urinal Flushometer with the following features: • �''" \ PERMEX®Synthetic Rubber Diaphragm with Dual Filtered Fixed Bypass • ADA Compliant Metal Oscillating Non-Hold-Open Handle with Triple Seal Handle Packing s/"I.P.S.Screwdriver Bak-Chek®Angle Stop w/Free Spinning Vandal Resistant Stop Cap Adjustable Tailpiece High Back Pressure Vacuum breaker flush connection w/one-piece bottom hex coupling nut Spud Coupling and Flange for 3/4"Top Spud Sweat Solder Adapter w/Cover Tube&Cast Wall Flange w/Set Screw \ High Copper,Low Zinc Brass Castings for Dezincification Resistance Non-Hold-Open Handle,Fixed Metering Bypass and No External Volume Adjustment to Ensure Water Conservation Flush Accuracy Controlled by CID Technology • Diaphragm,Handle Packing,Stop Seat and Vacuum Breaker molded from PERMEX Rubber Compound for Chloramine Resistance • 100%of the energy used in manufacturing is offset w/Renewable Energy Sources—Wind Energy Ij Valve Body,Cover,Tailpiece and Control Stop shall be in conformance with ASTM Alloy • �� Classification for Semi-Red Brass.Valve shall be in compliance to the applicable sections of ASSE 1037 and ANSI/ASME A112.19.2. Variations ❑HL-3 3"Metal Oscillating Push Button on front of valve (does not meet ADA requirements) ❑SG SaniGuard®Antimicrobial Coating Protects Handle and Socket" "SaniGuard does not protect users or others against disease-causing bacteria. Accessories See Accessories Section of the Sloan catalog for details on these and other flushometer variations. Fixtures - r-21/4'MIN. Contact Sloan for Sloan brand matching fixture options. (57mm) ® Made In The 3/a"I.P.S. J(292m SUPPLY USA cap 'I"'�a1mm)I (DN 20mm) t121mm) BEPA CENTERLINE GREEN '; U P C OF FIXTURE •wr>r (POWER Renewable Energy P pARTN„ER pp o'ibYf bwM KKIW d IhtmyM�l{uU�P1 JrDrd u�b p e W M h0.\,M�aiY This space for Architect/Engineer approval Job Name Date LFIN. FLOOR Model Specified Quantity _ Variations Specified . CustomefNAutesaler N. Contractor -`1 Architect The information contained in this document is subject to change without notice. SLOAN® SLNSS-FV/RYL186—Rev.2(06/13) SLOAN HEADQUARTERS•10500 SEYMOUR AVENUE•FRANKLIN PARK,IL 60131 ©2013 SLOAN VALVE COMPANY Ph:1-800-982-5839•Fax:1-800-447-8329•www.sloanvalve.com -__, cry ;x,•> NE 0 FM Residential Duplex f• 1 Grinder System 1 hp _ 2" Discharge Compact duplex system - 1, designed for residential ` !! sewage applications. f Perfect for basement ► bathroom additions and remodeling projects. Available in 115V or 230V. Fully assembled from factory. • Robust system features a compact heavy-duty polyethylene basin and cover US Patent#s i • 46 Gallon capacity 7,520,736,7,563,082 Year Warranty &7,159.80G •System can be installed above or below floor level • 2-pumps provide secure uninterrupted service • Patented V-Slice"cutter technology shreds s == difficult solids such as feminine products, rags,towels and wipes that can jam solids-handling _ g pumps h� �'� • Easy access cover with QuickTree°technology- allows for quick float removal and servicing li� • Heavy-duty integrated rubber gaskets on covers •Secure 16 bolt cover-standard on all models. Passes 10'stack test � 00 u T 0 h 1.. 680 reTMEN QuickTree- Technology 1 JIIrC' Features: ' • QuickTree technology allows easy • access and removal of switches without disturbing pump or plumbing. • `"l i LI _ • Integrated rubber seals permanently � attached to cover. • Unique cord seal technology integrated into the inspection cover. • Shallow basin design (24") for easier installation in difficult soil/bedrock = ' • .. r locations. "- • Large 46 gallon capacity for longer pump cycles. • Integrally molded torque stops secure the pump in itsAV proper position. • Integrally molded anti- flotation collar. • Durable polyethylene - construction. h • Completely assembled. us Patent#s 7,520,736,7,563,082 &7,159,806 5 Performance Curve N ' 60 Hz. ■■■■■■■■■■ ■■■■ �■■■ W► _ ■■■■■ ice■■ ��� tl �',�''���1;,� '�� ' MNMMM WINE ONE 1 —001 1 MEMO ■ MEN EEO ►!\� . 11►. �� 1 hp. Residential Duplex Grinder Package 16 Stainless steel Integrated cord cover bolts seal technology -Optional top inlet location Integral entry attachgasketed permanently attached to Dover Vent connection . e- Separate inspection cover allows access ' to switches Y <' 46 gallon capacityfor WNW longer pump cycles In t . :i'; .::'f , tea• a shallow240 design i Integrally molded no-hub type inlet,4° QuickTree•removable float system allows easy access to switch- separate from pump. Schedule 80 PVC Stainless steel rod. -40 discharge pipe ——Integrally molded Molded anti-float collar-__ '': "torque tops"for o pump security US Patent 1 . 1' :0 IAPMO Listed Basin CORD WGT. The ProVore6W Basin MODEL HP VOLTS PHASE AMPS DISCHARGE LENGTH LBS is specifically designed P682XPRG101 1 115 1 12 2- 10' 151 to pass a 10'stack testand is IAPMO listed. P682XPRG102 1 230 1 6 2" 10' 151 CPC See specific PRG-Series literature thr complete pump performance and snecthcatlons For 25'powercord add"-2'sulfix to model number.Example P682XPRGIOI-2 Product Specifications ProVore TM Tnn 380 & ProVore 680 Series \1 Residential Grinder Packages W MA �I m c•+(I ME ProVoreT1380 & ProVoreT'"680 Series Dimensional Data P380 SYSTEM P680 SYSTEM [666.75mm] ACCESS COVER [752.48mm] [194.72mm] 0264" [194.72mm] 0295" 721 ,- 7 32., _ 32 a - 60.33m m] 2"NPT DISCHARGE 2"NPT DISCHARGE PORTS 3" AND VENT PORTS i 28 INJECTION MOLDED 2"OR 3"VENT PORT POLYPROPYLENE COVER UNI-SEAL TYPE GROMMET [114.30mm] [1 14.30mm] 04- 04 1" 2 [ ] 234.9 609.60mm 2 [ ] 24" [234.95mm] [609.60mm] ,, 9 1 " 24" 9 4 4 O Rotationally Molded Polyethylene basin - ❑ 0 PROPRIETARY AND CONFIDENTIAL THE INFORMATION CONTAINED IN THIS P382 & P682 SERIES DRAWING IS THE SOLE PROPERTY OF LIBERTY PUMPS,ANY REPRODUCTION DWG.NO. DIMENSIONAL IN PART OR AS A WHOLE WITHOUT THE WRITTEN PERMISSION OF LIBERTY PUMPS STfc REV, IS PROHIBITED, A DATE: A APPLICATION DO NOT SCALE DRAWING SCALE:1:9 H S,!!i 1 OF 1 ProVore380-680 R07-2013 CCopyright 2013 Liberty Pumps Inc. AO rights reserved. Specifications subject to change without notice- I BUILDING INSPECTION REPORT — PLUMBING (HWT) Permit No. 193 Address: 230 Burke Ave Contractor: Oso Plumbing Owner: St Andrew Orthodox Church Date: 10/18/2013 ❑ APPROVAL ❑ PARTIAL APPROVAL ❑ CORRECTION ❑ OTHER APPLIANCE: Underground Plumbing LOCATION OK: ❑ L&I: ❑ ROUGH-IN: M GVLr At" BRACING: ❑ INSULATION: ❑ �y VENTING: ❑ 18 INCHES OR FVIR: ❑ PRV 6 INCHES: ❑ PRV SET<210: ❑ PRV< 15OPSI: ❑ DRAIN: ❑ DRIP LEG: ❑ IMPACT PROTECTION: ❑ ACCESS: ❑ SHUT-OFF VALVE: ❑ COMBUSTION AIR: ❑ Date: 10/18/2013 Inspector: CITY OF ARLINGTON 238 N. OLYMPIC AVE - ARLINGTON, WA. 98223 PHONE; (360) 403-3551 BUILDING PERMIT Address:230 E Burke Avenue Permit#: 186 Parcel#:00461801500100 Valuation: OWNER APPLICANT CONTRACTOR Name:ST ANDREW ORTHODOX CHURCH Name:Chopelas and Associates Name:Wright Way Cleaning&Restoration Address:PO BOX 3466 Address:307 N Olympic Avenue,#208 Address:2100 196th Street SW,#141 City,State Zip:ARLINGTON,WA 98223 City,State Zip:Arlington,WA 98223 City,State Zip:Lynnwood,WA 98036 Phone: Phone:360-653-4615 Phone:877-276-7348 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City,State,Zip: City,State,Zip: Phone: Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Commercial CODE YEAR: 2012 STORIES: Basement CONST.TYPE: DWELLING UNITS 0 OCC GROUP: BUILDINGS: 1 OCC LOAD: PERMIT APPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY;NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HISMER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBCI 10/IRCI 10. SAL ''r, NOTICE:Sales tax re at to construction and construction n ateruds in the Cit lington must be reported on your sales tax return form an rlin on#3101. q -A 3 g ature Print Name Date Releas y to CONDITIONS Adhere to approved plans. Please call the water department if you need the water off for any reason. 360- 403-3526. THIS PERMIT AUTHORIZS ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION. PERMIT FEES Date Description Fee Amount 9/9/2013 Building Permit Fee $419.78 9/9/2013 Building Plan Review Fee $272.86 9/9/2013 State Building Code Surcharge Fee $4.50 Total Due: $697.14 Total Payment: $0.00 Balance Due: $697.14 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon lob Permit Information Date 9/4/2013 Permit Number 186 Project Name St.Andrews Orthodox Church Permit Type Commercial Site Address 230 E Burke Avenue Description rcial Alteration Valuate 0.00 Square Fe Status Applied Permit Issued Permit Expires Phone 360-653 4615 Email chopelasandassociates@gmail.com Occupancy Load Type of Construction Proposed Use Restroom Remodel Number of Stories 0 Assigned To Launa Peterson i Property Information Owner Information Parcel#:00461801500100 ST ANDREW ORTHODOX CHURCH ST ANDREW ORTHODOX CHURCH PO BOX 3466 230 E BURKE AVE ARLINGTON,WA 98223 Contractors I Contractor Name Primary Contact Phone Email Contractor Type License I License# Chopelas and Associates Peter Chopelas 360-653-4615 chopelasandassociates@gmail.com JAIA/PE Review Date Type Description Target Date Completed Date Assigned To Status 9/4/2013 Commercial T.I 9/9/2013 Chris Young l In Review 9/4/2013 Commercial T.I 9/9/2013 Launa Peterson In Review 9/4/2013 Commercial T.I 9/9/2013 I PW Admin Rev In Review 9/4/2013 Commercial T.I. 9/9/2013 PW-CCC-Rev In Review 9/4/2013 Commercial T.I. i 19/9/20113 PW-Sew-Rev ,In Review 9/4/2013 Commercial T.I. 1 19/9/20113 PW-Wat-Rev In Review Notes Date Note 9/4/2013 Remodeling restrooms for ADA compliance.Adding a grinder pump. Email History Date Emalled To 9/4/2013 kwallace@arlingtonwa.gov;Itaylor@arlingtonwa.gov,PW-CCC-Rev@arlingtonwa.gov,PW-Wat-Rev@arlingtonwa.gov,PW- L Sew-Rev@arlingtonwa.gov i Uploaded Files I Upload File I Date File �_ 9/4/2013 �BLD-186 Plan.odf Delete 9/4/2013 1BLD-186 ApolicatM1A. f Delete COMMERCIAL REMODEL PERMIT APPLICATION _ Department of Community Development City of Arlington • 238 N Olympic Ave. •Arlington,WA 98223 • Phone (360)403 3551 • FAX (360)403 3418 THIS APPLICATION MUST BE ACCOMPANIED BY THREE(3)SETS OF CONSTRUCTION PLANS, THREE(3)SETS OF SPECIFICATIONS, TWO(2) SETS OF STRUCTURAL CALCULATIONS, ONE(1)SETS OF NREC ENERGY CODE APPLICATIONS AND ONE(1) OCCUPANTS'S STATEMENT OF INTENDED USE. Type of Permit: b Commercial Remodel Commercial Addition Tenant Improvement Project Address: 4Z� C • ��1�1L Ste, Parcel ID#: Project Description Legal Description Project Valuation: Q►17moJeA Owner: CL4 tltz C,bt Phone Number: Address: p City: State: L V%� Zip Code: 4 Contact Person: 'PE?6f Phone Number: bo - d 5;3- 49 15 Cell Phone: Fax: E-mail C �o n��u S c hvl G SS ocl�. T J Address: 17.0-1 tJ. CX1-_4 Ani C_ Zo ity:_ A-ILL,N'r-royj State: .0 A. Zip Code: Contractor: Phone Number: Address: City: State: Zip Code: Contractor's License Number: Expiration. Plumbing Contractor: Phone Number: Address: City: State: Zip Code: Contractor's License Number: Expiration: Mechanical Contractor: Phone Number: Address: City: State: Zip Code: Contractor's License Number: Expiration: 1 hereb ertify t the abov 'information is correct and that the construction on, and the occupancy and the use of the above- desc' rt ll be i cor nce with the laws, rules and regulation of the State f Washington � Applicant Signature Date RECEIVE[ Print Applicants Name SEP 0 4 2013 NDeDt. FOR STAFF USE ONLY Permit# Acd to By Amount Received Receipt# Date Received Web Forms—146 Page 6 of 7 7/10CJY COMMERCIAL REMODEL PERMIT APPLICATION Department of Community Development City of Arlington • 238 N Olympic Ave. •Arlington, WA 98223 • Phone (360)403 3551 • FAX(360)403 3418 Project Name/Tenant Site Address Bldg/Unit/Suite IBC Construction Type IBC Occupancy Type Description of Use Building Square Footage Number of Stories Square Footage Per Floor Will there be any installation, modification or removal of the following? (Check all that apply) ❑ Automatic fire extinguishing systems ❑ Compressed gas systems ❑ Fire alarm and detection systems ❑ Fire pumps ❑ Flammable and combustible liquids(tanks, piping etc ) ❑ Hazardous materials ❑ High piled/rack storage ❑ Industrial ovens/furnace ❑ Private fire hydrants ❑ Spraying or dipping operations i] Standpipe systems ❑ Temporary membrane structure,tents(>200sq ft)or canopies(>400 sq ft) Provide details on any of the above checked items: Installation,changes,modifications or removal of any of the above may require additional submittals, information,or permits during the plan review or construction process. Printed Name of Occupant/Agent Signature of Occupant/Agent Date Web Forms—146 Page 7 of 7 7/1 OCJY COMMERCIAL REMODEL PERMIT APPLICATION Department of Community Development City of Arlington • 238 N Olympic Ave. •Arlington, WA 98223 • Phone (360)403 3551 • FAX (360)403 3418 The following minimum information is required for your Commercial/Multi-Family Building Permit Application. Mark each box to designate that the information has been provided. Please submit this checklist as part of your submittal documents. Incomplete applications will not be accepted. ❑ One(1) City of Arlington Commercial/Multi-Family Permit Application (One permit application per building or structure is required) ❑ One(1) City of Arlington Commercial/Multi-Family Submittal Requirements Form ❑ Three (3) Site Plans ❑ One(1) 11"x 17"Site Plan ❑ Three (3)Architectural Drawings ❑ One (1) 11 "x 17" Set of Building Elevations ❑ Three (3) Structural Drawings ❑ Three (3) Structural Calculations ❑ One(1) Geotechnical Engineering Reports (if applicable) ❑ One(1) Project Specification Manuals (if applicable) ❑ One(1) NREC Code Compliance Forms ❑ One (1) Special Inspection Requirements Forms ❑ One (1) Occupant's Statement of Intended Use Form ❑ One(1) Letter of Verification of Water and Sewer Availability from City of Marysville (if applicable) Drawings shall be BOUND SEPARATELY BY TYPE, architectural, structural and landscape, and then ROLLED TOGETHER IN COMPLETE SETS> An intake appointment is required for all new Commercial or Multi-Family Building Permit Applications. To schedule an appointment please contact the City of Arlington Permit Center at(360)403 3551 or by email to Pre App Appointment Request. 1 acknowledge that all items designated above are included as part of this application. Applicant's Signature Date Web Fortes—146 Page 1 of 7 7/10CJY COMMERCIAL REMODEL j PERMIT APPLICATION Department of Community Development City of Arlington • 238 N Olympic Ave. •Arlington,WA 98223 • Phone (360)403 3551 • FAX(360)403 3418 A. FEES DUE AT TIME OF PERMIT APPLICATION The following non-refundable fees will be collected at the time of application for all tenant improvements projects. 1. Building Plan Check Fee B. CODES The City of Arlington currently enforces the following: International Codes 1. 2009 International Building Code(IBC) 2. 2009 International Residential Code(IRC) 3. 2009 International Mechanical Code(IMC) 4. 2009 International Fuel Gas Code(IFGC) 5. 2009 International Fire Code(IFC) 6. 2009 Uniform Plumbing Code(UPC) 7. 2009 International Property Maintenance Code(IPMC) 8. 2003 Accessible&Usable Buildings and Facilities(ICC/ANSI 1417.1) Washington State Amendments 1. WAC 51-50 Washington State Building Code 2. WAC 51-51 Washington State Residential Code 3. WAC 51-52 Washington State Mechanical Code 4. WAC 51-54 Washington State Fire Code 5. WAC 51-56&51-57 Washington State Plumbing Code and Standards 6. WAC 51-11 Washington State Energy Code 7. WAC 51-13 Washington State Ventilation and Indoor Air Quality Code 8. WAC 296-46B Electrical Safety Standards,Administration, and Installation C. CITY OF ARLINGTON DESIGN REQUIREMENTS Design Wind Speed: 85 miles per hour(Exposure C) Ground Snow Load: 25 pounds per square foot Seismic Zone: D2 Rainfall: 2 inches per hour for roof drainage design. Frost Line Depth: 12 inches Soil Bearing Capacity: 1,500psf unless a Geo-Technical Report is provided. (IBC Table 1804.2&IRC R401.4.1) D. PLANS AND DRAWINGS Submit three(3)complete sets of drawings and plans. Drawings and plans must be submitted on minimum 18"X 24", or maximum 30"X 42"paper.All sheets are to be the same size and sequentially labeled. Plans are required to be clearly legible, with scaled dimensions, in indelible ink, blue line, or other professional media. Plans will not be accepted that are marked preliminary or not for construction,that have red lines, cut and paste details or those that have been altered after the design professional has signed the plans. Please Note:A separate submittal of plans is required for each building or structure. Web Forms—146 Page 2 of 7 7/10CJY COMMERCIAL REMODEL PERMIT APPLICATION Department of Community Development City of Arlington • 238 N Olympic Ave. •Arlington,WA 98223 • Phone (360)403 3551 • FAX (360)403 3418 DETAILED SUBMITTAL REQUIREMENTS Mark each box to designate that the information has been provided. Please submit this checklist as part of your submittal documents A. ❑ SITE PLAN—REQUIRED WITH ALL SUBMITTALS (May be included as part of the Architectural Drawing cover Sheet) 1. Drawing shall be prepared at scale not to exceed 1"=20 feet. 2. Show building outline and all exterior improvements. 3. Provide property legal description and show property lines. 4. Provide dimensions from the property lines to a minimum of two building corners(or two identifiable locations for irregular plan shapes). 5. Show building set backs,easements and street access locations. 6. Indicate North direction. 7. Indicate finish floor elevation for the first level. 8. Provide topographical map of the existing grades and the proposed finished grades with maximum five feet elevation contour lines. 9. Show the location of all existing underground utilities, including water,sewer, gas and electrical. 10. Flood hazard areas,floodways, and design flood elevations as applicable. B. ❑ ARCHITECTURAL DRAWINGS 1 ❑ Cover Sheet a) Building Information 1. Specify model code information. 2. Construction Type. 3. Number of stories and total height in feet. 4. Building square footage(per floor and total) 5. IBC Occupancy Type(show all types by floor and total). 6. Mixed-use ratio(if applicable) 7. Occupant load calculation(show by occupancy type and total) 8. List work to be performed under this permit b) Design Team Information 1. Design Professional in Responsible Charge 2. Architects 3. Structural Engineers 4. Owner 5. Developer 6. Any other Design Team Members 2. ❑ Floor Plan a) Plan view 1/8"minimum scale. Details a minimum '/<-inch scale. b) Plans must show the entire tenant space. c) Specify the use of each room/area. d) Provide an occupant load calculation on the floor plan. (on every floor, in all rooms and spaces) e) Show ALL exits on the plans; include new, existing or eliminated. f) Show Barrier-Free information on the drawings. Web Forms—146 Page 3 of 7 7/10CJY g) Show the location of all permanent rooms,walls and shafts. h) Note the uses in the adjacent tenant spaces, if applicable. i) Provide a door and door hardware schedule. j) Show the location of all new walls, doors,windows, ect. k) Provide details and assembly numbers for any fire resistive assemblies. 1) Indicate on the plans all rated walls, doors,windows and penetrations. m) Provide a legend that distinguishes existing walls,walls to be removed and new walls. 3. ❑ Reflected Ceiling Plan a) Plan view 1/8"minimum scale. Details a minimum%-inch scale. b) Provide ceiling construction details. c) Provide suspended ceiling details complying with IBC 803.9.1.1. Show seismic bracing details. d) Show the location of all emergency lighting and exit signage. e) Detail the seismic bracing of the fixtures. f) Include a lighting fixture schedule. 4. ❑ Framing Plan a) Specify the size, spacing,span and wood species or metal gage for all stud walls. b) Indicate all wall, beam and floor connections. c) Detail the seismic bracing for all walls. d) Include a stair section showing rise, run,landings, headroom, handrail and guardrail dimensions. 5. 0 Storage Racks (if applicable) a) Structural calculations are required for seismic bracing of storage racks eight feet or greater in height. b) Eight feet or less,show a positive connection to floor or walls. NOTE: High pile storage shall meet the requirements of current International Building and Fire Codes. C. ❑ SPECIAL INSPECTION 1. Where special inspection is required by IBC 1704,the registered design professional in responsible charge shall prepare a special inspection program that will be submitted to the City of Arlington and approved prior to issuance of the building permit to comply with IBC 106.1. D. ❑ WASHINGTON STATE ENERGY CODE 1. Two completed Washington State Non-Residential Energy Code Envelope Summary forms. E. ❑ OCCUPANT'S STATEMENT OF INTENDED USE 1. The Occupant's Statement of Intended Use form shall be completely filled out and may require the submittal of a Hazardous Materials inventory Statement(HMIS). Contact the Arlington Web Forms—146 Page 4 of 7 7/10CJY ' COMMERCIAL REMODEL PERMIT APPLICATION Department of Community Development City of Arlington • 238 N Olympic Ave. •Arlington, WA 98223 • Phone (360)403 3551 • FAX (360)403 3418 The building permit does not include any mechanical, electrical, plumbing or fire sprinkler/alarm work. These permits are issued separately. Mechanical, electrical, plumbing, or fire sprinkler/alarm permits require a separate permit application and may also require separate plan review. Please note that any tenant improvement work in a space that involves food handling or preparation requires Snohomish County Health District approval before the permit can be issued. You must provide the Permit Center a copy of the approval letter or the approved plans. Contact the Snohomish County Health District at(425)339-5250 with any questions or for more information. An intake appointment is required for all large Tenant Improvement Building Permit Applications.To determine if your project requires an intake appointment,to schedule an appointment or to ensure that you have the most current information, please contact the City of Arlington Permit Center at(360)403-3551 or by email to permiteenter a�ci.arlington.wa.us. Application by courier or mail will not be accepted. Incomplete applications will not be accepted. I acknowledge that all items designated as submittal requirements must accompany my Building Permit Application to be considered a complete submittal. Signature: Date: Owner/Owner's Representative Company: Phone: Web Forms—146 Page 5 of 7 7/10CJY CITY OF ARLINGTON 238 N.OLYMPIC AVE.-ARLINGTON,WPC 98223 PHONE:(360)403-3551 _ BUILDING PERMIT Address:230 E BURIKE AVF,ARLINGTON Permit#:BLD20120249 Parcel#:00461801500100 Valuation:$1,200.00 bWN i APPLICANT,W ONI1�ACJQP ST ANDREW ORTHODOX CHURCH ST ANDREW ORTHODOX CHURCH DAVID SOMMER DAVID HOVIK DAVID HOVIK SNOHOMISH,WA 230 E BURKE AVE 22426 121ST DR NE ARLINGTON,WA 98223 ARLINGTON,WA 98223 Lie#: Exp: PLUMING CONTRACTOR NISCHANICAL CONTRACTOR Lie#: Exp Lie#: Exp: JOB DESCRIPTION Remodel PERMIT TYPE: Commercial PERMIT GROUP: Alteration/Remodel Interior STORIES: 0 CONST TYPE: DWELLINGUNITS: 0 OCC GROUP: CODE: OCC LOAD: PERMIT APPROV'AL --­ -_ _ 1 AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED,IBC110/IRCI 10. SALES TAX NOTICE: Sales . elating to construction and construction materials in the City of Arlington must be reported on your sales tax return form and code y Ar I 10 L iff% &6, k,646LI - S toe Print Name Date eleased Date/ ARCHIVE APPLICANT ASSESSOR OTHER o a " I N ab v r 0. di (SN 0 r. r rn z O Q z G cn D "rl cn c w oon �7 �1 m CAI I� { i 1 3 z 0 TM m Q R � � n � z —i� z 1'17 -_ Co no C-) 0 rn O N O 1p „N W w fI oho W c) sw UQ N N x 0\ 'O >e• (D m 0 m co sa• aim tat CD CD �o 0 •a i wsw i t 0 r 1 C. C co CD \ \ \ No to i w , w ! 00 %• tI -- �1i �. . I� O p� 0 O .r f� TJ fD1 N 'CD �O .N f � W w w i W w n I ' � N to �O N cn 1� a 0 �1 3 � II ! � loxlI CD CD 00 I� N N O r ; 7 N a O � O 0 -d II r. �. i •�•,/� s.+mow w �• ,�►1�. a r: . BLD20120249 (PT-LIVE) -PermitTrax by Bitco Software Page 1 of 1 BUILDING PERMI. PERMIT#: BLD20120249 OWNER: ST ANDREW ORTHODOX CHURCH-HO... STATUS:APPLIED ADDRESS: 230 E BURKE AVE,ARLINGTON BALANCE: $0.00 ISSUED: CREATED: 10/10/2012 SCREENS: Select Screen... --� FUNCTIONS: Select Permit Function... ALTERATION/REMODEL INTERIOR REVIEWS PRINT ADD NEW SUMMARY REVIE.. DESCRIPTION ASSIGNE.. DUE DATE LAST (#) REQ? DQ.. ASSIGN REMOVE 2000 C-Building I CYOUNG 10/17/2012 0 Y N Assign Remove 2008 C-Community Development I ARUSKO 10/17/2012 0 Y N Assign Remove https://coapermits.arlington.local/PermitTrax/Module Permits/Permits Permit/Permit Reviews.... 10/10/2012 COMMERCIAL REMODEL 42 PERMIT APPLICATION Department of Community Development City of Arlington • 238 N Olympic Ave. •Arlington, WA 98223 • Phone (360)403 3551 • FAX(360)403 3418 THIS APPLICATION MUST BE ACCOMPANIED BY THREE(3)SETS OF CONSTRUCTION PLANS, THREE(3) SETS OF SPECIFICATIONS, TWO(2)SETS OF STRUCTURAL CALCULATIONS, ONE(1)SETS OF NREC ENERGY CODE APPLICATIONS AND ONE(1) OCCUPANTS'S STATEMENT OF INTENDED USE. Type of Permit: (CP Commercial Remodel Art/ommercial Addition (Q Tenant Improvement Project Address: 1A Ck P &A Parcel ID#: Project Description: r= ^ 7 I g1AM0 p LA4 6&1 S. JjK144 Legal Description 6o U Project Valuation: _ Owner: Phone Number: 36 d .,y3,j— / 9 G CT Address: ICity: State: Zip Code: q g7z3 Contact Person: a V I 9V i"�l Phone Number i l !�NumberyZS3 yS' 9.53(� 1 Cell Phone: S JI7nA9_ Fax: E-mail: 't'Y&f3 '! KQ ArA5 . {A r Address:l Zy Z6V r A(le" City: State: ih!►4 Zip Code: 'I R 7-7-3 Contractor: j/i `�:_s IAAJM&11C Phone Number: 7— I Z,3 Address: City. State: J F 6_ Zip Code: Contractor's License Number: Expiration: Plumbing Contractor: Phone Number: Address: City State: Zip Code Contractor's License Number: Expiration: Mechanical Contractor: Phone Number: Address City State: Zip Code: Contractor's License Number: Expiration hereby certify that the above inform tion is correct and that the construction on, and the occupancy and the use of the above- described propert willpp�m cor ith the laws, rules and regulation of the State of Washington. �f. AV 4r� b1� I ►o—A-2Q Iz_ pplic is Sign tur Date v, 4 1z", 4 Print Applicants Name RECEIVED FOR STAFF USE ONLY Ow 2V11}o;�r�q - C� �� - COA PERMIT CEKER Permit# Accepted By Amount Received Receipt# Date Received Web Forms—146 Page 6 of 7 7/10CJY COMMERCIAL REMODEL ~ } ' PERMIT APPLICATION Department of Community Development City of Arlington • 238 N Olympic Ave. •Arlington, WA 98223 • Phone (360)403 3551 • FAX(360) 403 3418 Project Name/Tenant U"l-ewll/ 6 &k6-)( Site Address Z 3o E. , F22(LIC VQ, } -2, Bldg/Unit/Suite IBC Construction Type IBC Occupancy Type Description of Use Building Square Footage Z A Number of Stories Square Footage Per Floor Will there be any installation, modification or removal of the following? (Check all that apply) ❑ Automatic fire extinguishing systems ❑ Compressed gas systems ❑ Fire alarm and detection systems ❑ Fire pumps ❑ Flammable and combustible liquids(tanks, piping etc...) ❑ Hazardous materials ❑ High piled/rack storage ❑ Industrial ovens/furnace ❑ Private fire hydrants ❑ Spraying or dipping operations ❑ Standpipe systems ❑ Temporary membrane structure,tents(>200sq ft)or canopies(>400 sq ft) Provide details on any of the above checked items: Installation,changes,modifications or removal of any of the above may require additional submittals, information,or permits during during the plan review or construction process. Ur LY r 1�• I�C T1L( r- J� IC Printed Name oyc t/ ge RECEI WED D V&1)'fif ' �iLAiA) .A�� I h- R-7 OCT 092012 Signature of Occupant/Agent Date ft PERMIT CENTElt Web Forms—146 Page 7 of 7 7/10CJY COMMERCIAL REMODEL PERMIT APPLICATION Department of Community Development City of Arlington • 238 N Olympic Ave. -Arlington, WA 98223 • Phone (360)403 3551 • FAX(360)403 3418 The following minimum information is required for your Commercial/Multi-Family Building Permit Application. Mark each box to designate that the information has been provided. Please submit this checklist as part of your submittal documents. Incomplete applications will not be accepted. ❑ One (1) City of Arlington Commercial/Multi-Family Permit Application (One permit application per building or structure is required) ❑ One (1) City of Arlington Commercial/Multi-Family Submittal Requirements Form ❑ Three (3)Site Plans ❑ One(1) 11"x 17"Site Plan ❑ Three(3)Architectural Drawings ❑ One (1) 11 "x 17" Set of Building Elevations ❑ Three(3) Structural Drawings ❑ Three(3) Structural Calculations ❑ One (1) Geotechnical Engineering Reports (if applicable) ❑ One (1) Project Specification Manuals (if applicable) ❑ One (1) NREC Code Compliance Forms ❑ One (1) Special Inspection Requirements Forms ❑ One(1) Occupant's Statement of Intended Use Form ❑ One(1) Letter of Verification of Water and Sewer Availability from City of Marysville(if applicable) Drawings shall be BOUND SEPARATELY BY TYPE, architectural, structural and landscape, and then ROLLED TOGETHER/N COMPLETE SETS> An intake appointment is required for all new Commercial or Multi-Family Building Permit Applications. To schedule an appointment please contact the City of Arlington Permit Center at(360)403 3551 or by email to Pre App Appointment Request. I acknowledge that all ite s designated above are included as part of this application. 1? RECEIVE® Applicant's Signature Date OCT 092012 COA PERMIT CENTER Web Forms—146 Page 1 of 7 7/10CJY ' COMMERCIAL REMODEL PERMIT APPLICATION Department of Community Development City of Arlington • 238 N Olympic Ave. •Arlington, WA 98223 • Phone (360)403 3551 • FAX(360)403 3418 The building permit does not include any mechanical, electrical, plumbing or fire sprinkler/alarm work. These permits are issued separately. Mechanical, electrical, plumbing, or fire sprinkler/alarm permits require a separate permit application and may also require separate plan review. Please note that any tenant improvement work in a space that involves food handling or preparation requires Snohomish County Health District approval before the permit can be issued.You must provide the Permit Center a copy of the approval letter or the approved plans. Contact the Snohomish County Health District at(425)339-5250 with any questions or for more information. An intake appointment is required for all large Tenant Improvement Building Permit Applications. To determine if your project requires an intake appointment,to schedule an appointment or to ensure that you have the most current information, please contact the City of Arlington Permit Center at(360)403-3551 or by email to permitcenter(a)ci.arlington.wa.us. Application by courier or mail will not be accepted. Incomplete applications will not be accepted. acknowledge that all items designated as submitt requirements must accompany my Building Permit Application to be considered a complete submittal. Signature: Date: 1 — Owner/Owner's epresen ative /- U Company: yA840a\IVn (�X �/1[4?I/I Phone: 3 4 O I �s'1p 3 3 RECEIVED OCT 0 9 2012 COA PERMIT CENTER Web Forms—146 Page 5 of 7 7/10CJY