HomeMy WebLinkAbout5809 Circle Bluff Dr_BLD5106_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: BLD5106 Permit Type: Residential Mechanical
Address/Parcel: 5809 Circle Bluff Dr Completed (Month/Year): March 2023
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 ❑✓ 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 ❑ Other:
❑ Recorded Copies
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CITY OF ARLINGTON
18204 59th Avenue NE,Arlington,WA 98223
INSPECTIONS:360-403-3417-Permit Center:360-403-3551
5809 CIRCLE BLUFF DR Permit#: 5106
PERMIT EXPIRES 180 DAYS AFTER
Parcel#:00915800003400 DATE OF ISSUANCE.
Scope of Work:hike and kind fumace change out Valuation:7111.00
KALKO ALEKSANDR&GALINA CM HEATING CM HEATING INC
707 HAWTHORNE UNIT C4 1500 INDUSTRY ST 1500 INDUSTRY ST STE 200
EVERETT,WA 98201 EVERETT,Wa,98203 EVERETT,WA 98203
4252590550 425-259-0550
LTC:CMHEAI*095R4 EXP:05/04/2023
CM HEATING INC
1500 INDUSTRY ST STE 200
EVERETT,WA 98203
425-259-0550
LIC#:CMHEAI*095R4 EXP: 05/04/2023 LIC#: EXP:
PERMIT TYPE: RESIDENTIAL MECHANICAL CODE YEAR: 2018
STORIES: CONST.TYPE:
DWELLING UNITS: OCC GROUP:
BUILDINGS: OCC LOAD:
The issuance or granting of this permit shall not be construed to be a permit for,or approval of,any violation of this Code or any
other ordinance or order of the City,of any state or federal Law,or of any order,proclamation,guidance advice or decision of the
Governor of this State. To the extent the issuance or granting of this permit is interpreted to allow construction activity during any
period of time when such construction is prohibited or restricted by any state or federal law,or order,proclamation,guidance advice
or decision of the Governor of this State,this permit shall not authorize such work and shall not be valid.The building official is
authorized to prevent occupancy or use of a structure where in violation of this Code,any other City ordinances of this jurisdiction or
any other ordinance or executive order of the City,or of any state or federal law,or of any order,proclamation,guidance advice or
decision of the Governor. The building official is authorized to suspend or revoke this permit if it is determined to be issued in error or
on the basis of incorrect,inaccurate or incomplete information,or in violation of any City ordinance,regulation or order,state or
federal law,or any order,proclamation,guidance or decision of the Governor.
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. IBC I 10/IRCI 10.
SALES TA N0110,': Sales tax relating to construction and construction materials in the City of Arlington must be reported on
your sales tax return form and coded City of Arlington#3101.
01/04/2023
App ant a Date Building Official Date
Adhere to approved appliance. Approved pernut shall be onsitc during installation. Call for final ntspection.
THIS PERMIT AUTHORIZES 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.
Date Description Fee Amount
01/04/2023 Processing/Technology $25.00
01/04/2023 Inspection $75.00
01/04/2023 Mechanical Base $25.00
01/04/2023 Gas Piping/Units $15.00
01/04/2023 Forced Air Heat<100 BTU/h $15.00
01/04/2023 Credit Card SeNce $4.65
Total Due: $159.65
Total Payment: $159.65
Balance Due: $0.00
Call by 3:30 pm for next day inspection, allow 48 hours for Fire Inspections
When calling for an inspection please leave the following information:
Permit Number,Type of inspection being requested, and whether you prefer morning or afternoon
IVSPC`C'Tit1N
RIM,
RESIDENTIAL MECHANICAL APPLICATION
1WCommunity and Economic Development
City of Arlington• 18204 59th Ave NE•Arlington,WA 98223 •Phone(360)403-3551
This application is for new, addition, altered or replaced mechanical installation and new or altered gas piping.
Please fill out all pages of this application and include all information.
Type of Permit: ❑ New Installation 0 Addition/Alteration/Repair ❑ Gas Piping
Property Address: 5809 Circle Bluff Dr Project Valuation: 7111.86
Lot#: Parcel ID No.: 00915800003400 Preferred Contact: ❑ Owner O Contractor
Project Description: like and kind furnace swap
Owner Name: Bart BIXel Home No.: 4255519216
Email Address: bixelb@gmail.com gmail.com Cell No.:
Mailing Address: 5809 Circle Bluff Dr City: Arlington State: wa Zip: 98223
Contractor Name: CM Heating Office No.: 4252590550
Email Address: hhageage@cmheating.com Cell No.:
Mailing Address: 1500 Industry st City: everett State: Wa Zip: 98203
L&I Contractor License Number: CMAIRAP78ONH Expiration Date: 08/2024
• New gas piping requires a pressure test hooking to any appliance
• Sediment traps (drips)are required on all gas lines
• Gas lines are required to be supported/secured every 6 to 8 feet
• Proper Combustion air and venting required for all appliances
• A shut-off valve is required within 6 feet of all appliances
Gas Piping Information O Not Applicable
❑CSST ❑ Brass ❑ Other
Proposed Piping Material:
❑ Black Steel ❑ Galvanized Steel
Proposed Piping Size: ❑ Y2" ❑ 5/s" ❑ 3/4" ❑ 1" ❑ 1Y2" ❑ 2"
Distance from Meter to furthest Appliance: Total BTU's of all Appliances:
MECHANICAL PERMIT FEES jlpe v t)
'Type of Fixture No.of Units Cost er Unit Subtotal Model No.
Additional Plan Review fees x $75.00 =
Air Cond.Unit<_100Btu h x $15.00 =
Air Cond.Unit>100Btu h x $25.00 =
Air Cond.Unit>50013tu h x $50.00 =
Air Handling Units x $15.00 =
Base Mechanical Fee 1 x $25.00 = $25.00mmmmmmi
Boiler<10013tu h >3h x $ 15.00 =
Boiler>1 million Btu/h<50hp x $25.00 =
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Boiler>1.5 million Btu/h<50hp x $50.00 =
Boiler>100Btu h 3-15h x $15.00 =
Boiler>500Btu h 15-30hp x $25.00 =
Commercial Hoods-Type I x $25.00 =
Commercial Hoods-Type 11 x $50.00 =
Diffusers x $15.00 =
Dryer Ducting x $15.00 =
Ductwork(drawings required) x $25.00 =
Evaporative Coolers x $15.00 =
Exhaust Ventilation Fans x $15.00 =
Fire lace Insert Stove x $15.00 =
Forced Air Heat<_100 Btu h 1 x $15.00 = 15 S8X2A040M3PSAB
Forced Air Heat>100 Btu h x $25.00 =
Gas Clothes Dryer x $15.00 =
Gas Fired AC 15100 Btu h x $15.00 =
Gas Fired AC>100 Btu h x $25.00 =
Gas Fired AC>500 Btu h x $50.00 =
Gas Pi in <_5 units x $15.00 =
Gas Piping>5 units (plus<5 units x $2.00 =
Heat Exchangers x $15.00 =
Heat Pump-Condensing Unit x $25.00 =
Hot Water Heat Coils x $15.00 =
Miscellaneous Appliance-regulated by x $15.00 =
:mechanical code,not otherwise specified
Pkg.Units<_100btu x $25.00 =
Pica.Units>100btu x $50.00 =
Range/Cook to -Gas Fired x $15.00 =
Refrigeration Unit s100Btu h x $15.00 =
Refrigeration Unit>100Btu h x $25.00 =
'Refrigeration.Unit>500Btu/h x $50.00 Re-inspection fee x $75.00 =
.Residential Range Hood x $15.00 =
Unit Heaters<_100 Btu h x $15.00 =
'Unit Heaters>100 Btu h x $25.00 =
VAV Boxes(Variable Air Volume,part of air x $10.00 =
conditioning system)
'Wall Heaters-Gas Fired x $25.00 =
'Water Heater-Gas Fired x $25.00 =
Permit Fee 15
Inspection Fee $75.00
Processing/Technology Fee $25.00
Total 115
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PRESSURE PIPING SCHEMATIC
COMPLETE FOR GAS PIPING ONLY
SCHEMATIC IS TO SCALE SCHEMATIC NOT TO SCALE
Show Pipe Size(s) and Length(s) from meter to all appliances
NOTE:Any interior pressure regulators must be indicated
1 hereby certify that 1 am the ❑Owner, [D Applicant ❑Contractor, and authorized to sign this application and that the above
information is correct and construction on,and the occupancy and the use of the above-described property will be in accordance with
the laws, rules and regulation o State of Washington, and the City of Arlington.A final inspection and approval shall be obtained
when complete
Hannah Hageage 1/3/23
Jnat fr-e Print Name Date
SAVE
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