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Home My WebLink About111 OLYMPIC AVE_BLD1134_2026 Y COMMERCIAL REMODEL y�tIN o� PERMIT APPLICATION Department of Community& Economic Development City of Arlington • 18204 59th Ave NE•Arlington, WA 98223• Phone(360)403-3551 THIS APPLICATION MUST BE ACCOMPANIED BY TWO(2) SETS OF CONSTRUCTION PLANS, TWO(2)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: ( ) Commercial Remodel ( ) Commercial Addition �( Tenant Improvement Project Address: Q , Parcel ID#: Project Description: r ia iL ed2C Legal Description: Project Valuation: Owner: Phone Number: Address: ,,//�� City: State: Zip Code: Contact Person:, .� S,n IJ c,#16 1Z� Phone Number: G_, Cell Phone: E-mail: Address: City: State: Zip Code Contractor: cy to a✓^ 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: REV 2015 Page 6 of 7 • s COMMERCIAL REMODEL IN PERMIT APPLICATION Department of Community& Economic Development City of Arlington • 18204 59th Ave NE •Arlington, WA 98223 • Phone (360)403-3551 Project Name/Tenant A '�e v- ,,P r^ Site Address IBC Construction Type IBC Occupancy Type Description of Use 00 W-c P ,��sc Building Square Footage Number of Stories Ah_ Z 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 the plan review or construction process. I hereby certify th t the above information is correct and that the construction on,and the occupancy and the use of the above-described property will be i accordance with the laws, rules and regula'on of the State of Washington Applicants Signature Print Applicants Name Date FOR STAFF USE ONLY Permit# Accepted By Amount Received Receipt# Date Received REV 2015 Page 7 of 7 CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360) 403-3551 BUILDING PERMIT Address: III N Olympic Ave Permit#:1134 Parcel#:00378800601401 Valuation: 10750.00 OWNER APPLICANT CONTRACTOR Name:INTERNATIONAL CHURCH OF THE Name:Frank R Herbert Jr. Name:Lifeway Foursquare Church FOURSQUARE Address: 1910 W SUNSET BLVD#200 Address:I 11 Olympic Ave Address: I I I N Olympic Ave City,State Zip:LOS ANGELES,CA 90026 City,State Zip:Arlington,WA 98223 City,State Zip:Arlington,WA 98223 Phone: Phone:360-770-3576 Phone:360-770-3576 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 Alteration CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: 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 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. SALA TAX NOTICE:Sales tax relallng to construction and construction materials in the City of Arlington must be reported on your sales tax return form a ode 'ty of Signature Print Name Date RCleased By Date CONDITIONS Adhere to approved plans. 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 9/1/2016 Building Permit Fee $270.17 9/1/2016 Building Plan Review Fee $175.61 9/1/2016 State Building Code Surcharge Fee $4.50 Total Due: $450.28 Total Payment: $0.00 Balance Due: $450.28 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 Lifeway Fours qureChurch Cafe Floor Plan �k��s�� r►n��s 105North Olympic Ave t 47'-9" 23'-10" 23'-1 1 " c m 11' 13' s i s 32'-4" do� r Counter&Sink O 02, 10 �t-�n,� r�v� c�►rr,�l�..lti. o Cou nte r&Cabi nets 14'-6" co N 90 1 �" �' • cn COMQ�'�t�►t�.lT sla��, ExistingOven 22'-5" 49'-5" CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address: III N Olympic Ave Permit#:1134 Parcel#:00378800601401 Valuation: 10750.00 OWNER APPLICANT CONTRACTOR Name:INTERNATIONAL CHURCH OF THE Name:Frank R Herbert Jr. Name:Lifeway Foursquare Church FOURSQUARE Address: 1910 W SUNSET BLVD#200 Address:I 1 I Olympic Ave Address: I I I N Olympic Ave City,State Zip:LOS ANGELES,CA 90026 City,State Zip:Arlington,WA 98223 City,State Zip:Arlington,WA 98223 Phone: Phone:360-770-3576 Phone:360-770-3576 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 Alteration CODE YEAR: 2015 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. IBC1I0/IRC110. SAL VS TAX NOTICE:Sales tax rcladmz.to construction and construction materials in the City of Arlington must be reported on your sales tax return form ai ode t of it* # 1 ;L Signature Print Name Date Released By Date CONDITIONS Adhere to approved plans. 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 9/1/2016 Building Permit Fee $270 17 9/1/2016 Building Plan Review Fee $175.61 9/1/2016 State Building Code Surcharge Fee $4.50 Total Due: $450.28 Total Payment: $0.00 Balance Due: S450.28 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 _ i fMMtrrbzF � 27e- 17 i/ Permit Information Date 8/30/2016 Permit Number 1134 Project Name Lifeway Foursquare Church Applicant Name Frank R Herbert Jr. Applicant Address 111 Olympic Ave City, State,Zip Arlington,WA 98223 Contact Jim Donaldson Phone 360-770-3576 Email Permit Type Commercial Alteration Site Address 111 N Olympic Ave Valuation 10750.00 Status Applied Permit Issued Permit Expires Square Feet 4356 Type of Construction/Occupancy Load Number of Stories 2 Proposed Use T.I.for coffee house-new interior walls/partitions Assigned To Kristin Foster Property Information Owner Information Parcel#:00378800601401 INTERNATIONAL CHURCH OF THE FOURSQUARE INTERNATIONAL CHURCH OF THE FOURSQUARE 1910 W SUNSET BLVD#200 111 OLYMPIC AVE LOS ANGELES,CA 90026 Contractors Contractor Name Primary Contact Phone Email Contractor Type License �Lic�n # ILifeway Foursquare Church JJim Donaldson 360-770-3576 DWNER Review Date Type Description Tar et Date Completed Date Assigned To Status 3/30/2016 Commercial T.I. 3/6/2016 Kevin Olander Iln Review 3/30/2016 commercial T.I. 3/6/2016 PW Admin Rev In Review 3/30/2016 commercial T.I. 9/6/2016 PW-Wat-Rev In Review Uploaded Files Upload File Date File Uploaded B 8/31/2016 8:39:21 AM 11134 Plans. df Foster,Kristin 8/30/2016 9:58:57 AM ll134 Al2plication.pdf Foster,Kristin &Y U� COMMERCIAL REMODEL I'YG�o� PERMIT APPLICATION Department of Community&Economic Development City of Arlington • 18204 59th Ave NE •Arlington, WA 98223• Phone(360)403-3551 THIS APPLICATION MUST BE ACCOMPANIED BY TWO(2)SETS OF CONSTRUCTION PLANS, TWO(2)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. ��Tenant Type of Permit: ( ) Commercial Remodel ( ) Commercial Addition Improvement Project Address: /y Q , Parcel ID#: Project Description: +p r iCL_4,e 2 Legal Description: Project Valuation: r� Owner: Z' c i�ncLr C' Phone Number: Address: City: State: Zip Code: Contact Person: ti^ IJ o✓I G 1�� , j1 Phone Number: 3L O - 7 7n— -_1 Cell Phone: E-mail: Address: City: State: Zip Code: Contractor: d ..cam G7<£�f 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: REV 2015 Page 6 of 7 Y COMMERCIAL REMODEL PERMIT APPLICATION Department of Community&Economic Development City of Arlington • 18204 59th Ave NE •Arlington, WA 98223 • Phone(360)403-3551 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 ced@arlingtonwa.gov 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. REV 2015 Page 5 of 7 Y COMMERCIAL REMODEL PERMIT APPLICATION Department of Community& Economic Development City of Arlington • 18204 59th Ave NE •Arlington, WA 98223 • Phone (360)403-3551 Project Name/Tenant 4 er w 'O'V �fr e` �0/1 Site Address u f�Bldg./Unit/Suite IBC Construction Type IBC Occupancy Type Description of Use 00 we Building Square Footage Number of Stories__ Z 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 the plan review or construction process. I hereby certify th f the above information is correct and that the construction on,and the occupancy and the use of the above-described property will be i accordance with the laws, rules and regulafon of the State of Washington Applicants Signature Print Applicants Name Date FOR STAFF USE ONLY m,?4 - AUG 22 20IN Permit# Accepted By Amount Received Receipt# Date Received REV 2015 Page 7 of 7 �. � -� `• ::, :,,'� mac, �.._ r �Y� Y .r, Lifeway Foursquare Church Lifeway Cafe 105 North Olympic Ave COPY Arlington WA 98223 OFFICE August 19, 2016 Cafe Floor Plan Breakout, Framing- $6500.00 Drywall - $9000.00 Insulation- $3000.00 Plumbing$3000.00 -z _ 5v Contacts, Frank R. Herbert Jr. 425-231-8731 Jim Donaldson 360-770-3576 Lifeway Foursquare Church 107 North Olympic Ave Arlington,WA 98223 • r� � � � si i � t N •, Vil Q 91oc 9 Z 9nv P9AIGOa-d u9np6uilsix3 r�51t ��,rdwo� co V4--L TAM L 011z °9 ,bl 8 slauiquoVialunoo �-��vw Q;s �a� r►vaa � � s _ O )luis�gialunoo lo ol now ,£l Aill L do 3 8 U0103dSM aazwo�V A 8.,..., . t� VC , l l-,£z - .o l-,£a .6-,Lb a3AO)IddV anyoldul�ClO aoN50 JMWIWVd3Q ONIQlInG NO,LONI7'JO A.LID sVcquj y�►��t�-7- UBld a o oId 91B O yoanuoaanbsanod Aem9ji-1 AdOO 301AJO Permit#: 1134 Permit Date: 08/30/16 Permit Type: COMMERCIAL ALTERATION Project Name: Lifeway Foursquare Church Applicant Name: Frank R Herbert Jr. Applicant Address: 111 Olympic Ave Applicant, City, State, Zip: Arlington,WA 98223 Contact: Jim Donaldson Phone: 360-770-3576 Email: Scope of Work: T.I. for coffee house -new interior walls/partitions Valuation: 10750.00 Square Feet: 4356 Number of Stories: 2 Construction Type: Occupancy Group: ID Code: Permit Issued: 09/01/2016 Permit Expires: 03/01/2017 Form Permit Type: Status: COMPLETE Assigned To: Kristin Foster Property Parcel# Address Legal Description Owner Name Owner Phone Zoning INTERNATIONAL 691 Religious 00378800601401 111 OLYMPIC AVE CHURCH OF THE Activities(Churches FOURSQUARE Synagogues Etc. Contractors Contractor Primary Contact Phone Address Contractor Type License License Lifeway Foursquare Church Jim Donaldson 360-770-3576 111 N Olympic Ave OWNER Inspections Date Inspection Type Description Scheduled Date Completed Date Inspector Status 10/10/2016 C20.BUILDING Approved FINAL Plan Reviews Date Review Type Description Assigned To Review Status 08/30/2016 COMMERCIAL BUILDING ALTERATION 08/30/2016 COMMERCIAL No comments,LT PW-ADMIN-GIS ALTERATION 08/30/2016 COMMERCIAL Please see comments on permit 1135. pW-WAT-REV ALTERATION Gus Fees Fee Description Notes Amount Building Permit Table 4-1 $270.17 Building Plan Review Table 4-2 $175.61 State Surcharge- 1 st DU Residential- 1 st Unit $4.50 Total $450.28 Attached Letters Date Letter Description 09/01/2016 Building Permit Payments Date Paid By Description Payment Type Accepted By Amount 09/13/2016 Frank Herbert 61311534 cc $450.28 Outstanding Balance $0.00 Uploaded Files Date File Name 09/13/2016 1839883-1134 Issued Permit.pdf 08/31/2016 1819727-1134 Plans.pdf 08/30/2016 1816858-1134 Application.pdf Date: 03/11/2026 Permit#: 1134 Permit Date: 08/30/2016 Review Date: 08/30/2016 Permit Type: COMMERCIAL ALTERATION Review Type: COMMERCIAL ALTERATION Target Date: 09/06/2016 Scheduled Time: 00:00 Completed Date: 09/01/2016 Description: Please see comments on permit 1135. Gus Review Status: Assigned To: PW-WAT-REV Time In: 00:00 Time Out: 00:00 Hours: 0.0 Property Information Parcel#: 00378800601401 INTERNATIONAL CHURCH OF THE FOURSQUARE INTERNATIONAL CHURCH OF THE 1910 W SUNSET BLVD #200 FOURSQUARE 111 OLYMPIC AVE LOS ANGELES, CA 90026 Zoning: 691 Religious Activities (Churches Synagogues Etc.Lot: Block: