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Home My WebLink About430 N OLYMPIC AVE_00712_2026 CITY OF ARLINGTON CONSTRUCTION PERMIT ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN F� PERMIT NO. OWNER / // �f �M/AIL ADDRESS n CITY //�', / ZIPS/ PHONE? _ 2 A h �CT OR SIGNER x t• lI /�ARIL A /� ��(i/GrF/�✓/ P.DDRESS CrY r/�IS. ?10 � z3 PHONE�J C J�J Gr AL CON RACTOR MAIL RESS CITY ZIP PHONE UC NSEMEECCHANI AL CONTRACTOR MAIIL ADDRESS CITY ZIP PHONE LICENSE PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE# CLASS OF WORK P ❑NEW ❑ADDITION ❑ALTERATION REPAIR ❑DEMOLITION ❑BUILDING RELOCATION VALUATION OF WORK E DESCRIBE WORK LL L , PROPOSED 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- LEG AL DESCRIPTION OF PROPERTY(SHOWN BELOW OR ATTACH FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNINGTHIS TYPE OF WORK LOT-BLOCK-OF WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE GRANTING OFA PERMIT DOES NOT PRESUMETO GIVE AUTHORITYTO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR TAX ID NUMBER LOCAL LAW REGULATING CONSTRUCTION OFTHE PERFORMANCE OF CONSTRUCTI PE IT EXPIRES 1 YE FROM DATE OF ISSUANCE. SIGNATURE CO. CTO RAUT RIZEOAGENT DATE C/ jOB•f>t)URLSS� x (OFFICE USE ONLY) MECH ICAL PLUMBING NO, TYPE OF FIXTURE FEE NO. TYPE OF EQUIPMENT FEE WATER CLOSET (TOILET) AIAXOND, UNITS -H.P.EA. BA I I UB REFR116kRATION UNITS-H.P. EA. LAVA Y (WASH BASIN) BOILERS - P. EA SHOWER GAS FIRED A UNITS-TONNAGE EA. KI ICHEN SINK ISP. FORCED AIR SY MS- B T.U. MEA DISHWASHER WALL HEATERS- B. .0 M LAUNDRY TRAY UNI1 HEATERS- B.T. M CLOTHES WASHER EVAPORAT IVE COOLERS WAIERHEATER CLOTHES DRYERS URINAL VENTILATICN FAN DRINKING FOUNIAIN RANGE HOOD COMMERCIAL FLOOR DRAIN AIR HANDLING UNIT- CPM VACUUM BREAKERS STOVE ROOF DRAINS - RAINLEADERS METAL FIREPLACE&CHIMNEY SINK (SERVICE - BAR, ETC.) WATER HEATER GAS PIPING SUBTOTAL ; SUB TOTAL S PERMIT ; PERMIT ; TOTAL FEE ; TOTAL FEE ; SIDE YARD SE IBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE FEE RECEIPT NO. USE ZONE LOT AREA VACANT SITE ❑YES ❑NO FEES VALUATION FEE TYPE OF CONST, OCCUPANCY GROUP NO.OF DWELLING UNITS PLAN CHECKING NG NO.OF STORIES MAX,OCC.LOAD BUILDING $ SIZE OF BLDG, � PLUMBING FIRE SPRINKLERS REQUIRED ❑YES ❑NO MECHANICAL COMMENTS STATE BLDG.CODE ENERGY CODE SURCHARGE U.B.C. PENALTY SEC.303(a) WATER/SEWER FEES TOTAL ISO PERMIT VALIDATION WHEN PROP Y VALID TED (IN THIS SPACE) THIS IS YOUR PERMIT& � PAID CR#C BY gi_ cc: ASSESSOR,APPLICANT,TREASURER, BLDG. DEPT. BUILDING OFFICIAL DATE RECORDS COPY CITY OF ARLINGTON CONSTRUCTION PERMIT ❑ COMBINATION ® BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NOZO712 OWNER MAIL ADDRESS CITY ZIP PHONE Lyle Widmark 430 1/2 Olympic Ave Arlington, WA 98223 435--4053 ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE# C. Walter Smith MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE# PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE# CLASS OF WORK ❑NEW ❑ADDITION ❑ALTERATION ®REPAIR ❑DEMOLITION ❑BUILDING RELOCATION VALUATION OF WORK $ DESCRIBE WORK Roof Repair PROPOSE D USL 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- LL(.AL 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 OFA PERMIT DOES NOT PRESUMETO GIVE AUTHORITYTO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR TAX ID NUMBER LOCAL LAW REGULATING CONSTRUCTION OFTHE PERFORMANCE OF CONSTRUCTION. PERMIT EXPIRES T YEAR FROM DATE OF ISSUANCE. SIGNATURE OF MRACTOROR AUTHORIZED AGENT DATE jOB ADOR(SS 430. 1/2 North. Olympic Ave. X (OFFICE USE ONLY) MECHANICAL PLUMBING NO. TYPE OF FIXTURE FEE NO. TYPE OF EQUIPMENT FEE WATER CLOSET (TOILET) AIR COND, UNITS —H P EA BAIHTUB REFRIGERATION UNITS—HP 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 DISHWASHER WALL HEATERS— B-T.0 M LAUNDRY TRAY UNIT HEATERS— B.T.0 M CLO I HES WASHER EVAPORAT IVE COOLERS WATER HEATER CLOTHES DRYERS URINAL VENTILATICN FAN DRINKING FOUNTAIN RANGE HOOD COMMERCIAL FLOOR DRAIN AIR HANDLING UNIT— CPM VACUUM BREAKERS STOVE ROOF DRAINS - RAINLEADERS METAL FIREPLACE &CHIMNEY SINK (SERVICE — BAR,ETC) WATER HEATER GAS PIPING SUBTOTAL $ SUBTOTAL $ PERMIT $1 PERMIT $ TOTAL FEE $1 TOTAL FEE ; SIDE YARD SE TBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE FEE RECEIPT NO USE'ZONE LOT AREA VACANT SITE FEES VALUATION FEE ❑YES ❑NO TYPE OF CONST OCCUPANCY GROUP NO.OF DWELLING UNITS PLAN CHECKING NG BUILDING $ 40 00 SIZE OF BLDG. NO.OF STORIES MAX_OCC,LOAD PLUMBING FIRE SPRINKLERS REQUIRED ❑YES ❑NO MECHANICAL COMMENTS STATE BLDG.CODE ENERGY CODE SURCHARGE 4 50 UB PENALTY SECC303(a) ,RE:ROOF ONLY WATER/SEWER FEES TOTAL 44 50 PAID PERMIT VALID ION WHEN PROPE V IDATEO (IN THIS SPACE) THIS IS YOUR PERMIT&RECEIPT AUG 799 PAID 8/ 8/ 1 R# 2441 B DWA cc:ASSESSOR,APPLICANT,TREASURER, BLDG. DEPT. 115FMCIAlATE R CORDS COPY