HomeMy WebLinkAbout2233 STATE ROUTE 530 NE_BLD1148_2026 �1ly o� COMMERCIAL MECHANICAL
• PERMIT APPLICATION
��ilvGSp 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 DRAWINGS AND ALL
OTHER INFORMATION OUTLINED IN THE MECHANICAL PERMIT SUBMITTAL REQUIREMENTS, IF APPLICABLE.
Type of Permit: ❑ New Installation �✓ Replacement ❑ Alteration
Project Address: 2233 SR 530 NE, Arlington WA 98223 Parcel #: 310508-002-008-00
Replace existing propane tanks with Suburban Propane
Project Description:LP tanks. Valuation:
1,800.00
Owner:ARLINGTON 1-5 ARCO Phone#:360-652-8888
Address: 2146 Clover Ct City: Mukilteo State:WA Zip:98275
Email Address:
wmeek@suburbanpropane.com
ing
Contact Person: Phone #: 360-652-8888
Address:2233 SR 530 NE City:Arlington State: WA Zip: 98223
Email Address:wmeek@suburbanpropane.com
Contractor Name:Suburban Propane Phone #: 360-661-4105
Contractor Address: 12820 34th Ave NE City:Marysville State:WA Zip:98271
Email:wmeek@suburbanpropane.com Contact Person:Wayne Meek
Contractor License Number: 601690470 Expiration: 02/28/2017
Please indicate type of number of appliances:
FURNACE CONDENSING UNIT GAS PIPING OUTLET
BOILER HEAT PUMP(multi-split) UNIT HEATER
CHILLER HEAT PUMP(mini-split) PAINT BOOTH
COOLER HEAT PUMP(other) TYPE I HOOD
AC(air cooled) HEAT REJECTION EQUIP TYPE II HOOD
AC(water cooled) VENTILATION SYSTEM AST 2
AC(evaporator) PACKAGED UNIT UST
AC(VRF) DRYER OTHER
I 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 b rules and regulation of the fate of Washington.
Applicants Signature: �o Date 09/13/2016
Applicants Printed Name: Wayne E Meek
FOR STAFF USE ONLY
Permit# Accepted By Amount Received Receipt# Date Received
6/16LP Page 1 of 1
' CITY OF ARLINGTON
238 N. OLYMPIC AVE-ARLINGTON, WA.98223
PHONE; (360)403-3551
BUILDING PERMIT
Address:2233 State Route 530 Permit k:1148
Parcel H:31050800200900 Valuation: 1800.00
OWNER APPLICANT CONTRACTOR
Name:BIR SINGH ENTERPRISES INC Name:Suburban Propane Name:SUBURBAN PROPANE
Address:4414 220TH ST SE Address:12820 341h Ave NE Address:12820 34TH AVE NE
City,State Zip:BOTHELI.,WA 98021 City,State Zip:Marysville,WA 98271 City,State Zip:MARYSVILLE.WA 98 70
Phone: Phone:160-661-4105 Phone:360-659-1251
MECHANICAL CONTRACTOR PLUMBING CONTRACTOR
Name:SUBURBANPROPANL Name:
Address:12820 34TH AVE NE Address:
City,State,Zip:MARYSVILLE,WA 98270 City,State,Lip:
Phone 360-659-1251 Phone:
LIC#. EXI' LIC ff: F'XP
JOB DESCRIPTION
PERMIT TYPE: Commercial Mechanical CODE YEAR: 2015
STORIIS: 0 CONST.TYPE:
DWELLING UNITS: 0 OCC GROUP:
BUILDINGS: 0 OCC LOAD:
PERMIT APPROVAL
1 AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING 7IiE WORK AOTIIORIZF'.
THEREBY:NO PERSON WILL BL'EMPLOYED IN VIOLATION OF THE LA13OR CODE OF THE STATE OF WASHINGTON RF-I ATIN G TO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
THIS APPLICATION IS NOT A PERMIT UNTu.SIGNED BY THE BUILDING OFFICIAL OR HIS/HI.R DEPUTY AND ALL FEES ARE AID.
IT IS UNLAWFUI.'T SE OR OCCUPY A BUILDING OR STRUCTURF UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
ACE. 'IFICA'IE CUPANCY HAS BEEN GRANTED. IBCI10ARCt10.
SA1. . TAX TI -S s tax relating to construction and construction materials in the City glon m st be reported on your sales tax return Ihmi
and c ed 'tv of ingl 3101.,
Signature Print Narne Date RcI:a,ed t tc
CONDITIONS
Approved as submitted. An Labor and Industries inspection is required prior to a final mechan cal
inspection.
'THIS PERMIT AUTHORIZE ONLY THE WORK NOTED,THIS l`ERMrr COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY NY
CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,FTC.)WILL REQUIRE SEPARATE PERMISSION-
PERMIT FEES
Date Description Fi 9 Amount
9/23/2016 Mechanical Fee(Enter Fixture Fee) $25.00
9/2312016 Mechanical Permit Base Fee $25.00
9/23/2016 Mechanical Plan Review Fee $200.00
Total Due: S250.00
Total Payment: $0.00
Balance Uuc: S250.00
CALL FOR INSPECTIONS
RCILDING(360)403-3417
When calling for an inspection please leave the following information:
OPERATING
PERMIT APPLICATION
Department of Community& Economic Development
City of Arlington- 18204 591h Aye NI -Arlington. H'A 98223-Phone(360)403-3551
Part I
Applicant/Building Information
Applicant's Name: V4
Applicant's Address: 2 2 3 3 S P-- 5-36 & "
Contact Person: ,QAVk)C JL Telephone:
Address of Premises for which Operating Permit is requested:
Same as above ❑ Other(specify):
Tax Parcel ID#: 31 p Sd Y-pCja -DLzh-ors Current Occupancy Class:
Part II
Type of Operating Permit
An Operating Permit is required to conduct any activity or to use any class of building listed below. I lean
indicate the type(s)of Operating Permit(s) requested by checking each applicable box. (If you requir
assistance,or would like more information, contact the City of Arlington Building Department at 36(-403-
355 I.)
10Manufacturing, storing or handling hazardous materials in quantities exceeding those listed in the Fire
Code(see Appendix A.) Identify the materials and quantities and describe the manner in which the
materials will be manufactured, stored or handled (attach additional sheets if necessary):
QU,eA0A4K tP NWO_XA�0- U4 JqA:�S A_,o L4A-
`C-
Revised 4/l/08
Page 1 of 4
Part 11 (cont'd)
52"Conducting a hazardous process or activity, including, but not limited to, any commercial or indL strial
operation which produces combustible dust as a byproduct. fruit and crop ripening,waste handling, pray
operations,and high-piled storage (see Appendix B.) Describe the rocess(es)or activity(ies)to be
conducted (attach additional sheets if necessary): (�
VA
❑ Use of pyrotechnic devices in assembly occupancies(see Appendix C.) Describe the devices to I e used
and type of event(attach additional sheets if necessary):
Aboveground Storage Tank(AST)(see Appendix D)
❑ Removal ❑ Decommissioning ❑ Temporary lank closure FIChanges in service
❑ Permanent tank closure
Brief description: .Q S `
❑ Underground Storage Tank(UST)(see Appendix D)
❑ Removal ❑ Decommissioning ❑ Temporary lank closure ❑ Changes in service
❑ Permanent tank closure
Brief description:
❑ Temporary Membrane Structures, including tents and canopies (see Appendix E.) Brief descripti n of
structure and use:
Cc: Fire Department Page 2 of 4
Port H (cow'd)
❑ Special Event Operating Permit - An Operating Permit is required for any special event that takes
place within an occupied building, or an outdoor mass gathering, which is outside the scope of he
permitted use (see Appendix F.) Brief description of type of gathering proposed:
Part III
Premises/Building Information
l. Date of last inspection of Premises: ,
2. Has a Certificate of Occupancy been issued for the premises?[ Yes ❑ No
Type: dpermanentE] Temporary Date of Issuance:
3. Are there currently any open Building Permits associated with the premises? ❑ Yes [.`No
If yes, please describe (attach additional sheets if necessary):
4. Additional Comments:
SIGNATURE OF APPLICANT
1 herby certify t the foregoing in r ation (and all information in attached sheets. if any) is true al-d
complete.
� C
S nature o Applicant or Authorized Representatives Signature Date
- e &2
Name and Title(if applicable) of person signing Application (Please print)
Cc: Fire Department Page 3 of 4
Part IV
To be completed by the City of Arlington Building Department
Inspection Required: ❑ Yes ❑No
Inspections Performed: ❑ Yes ❑ No Date of Inspection:
Tests or Reports required verifying compliance? ❑ Yes ❑ No
If YES, have Tests or Reports been received? ❑ Yes ❑ No
Application(s) Approved: ❑ Yes ❑ No
Operating Permit Issued by:
Date Operating Permit Issued: Date Operating Permit Expires:
Type/Description of Operating Permit:
Conditions of Operating Permit (list conditions here AND in the space provided in the Operating Per it):
Additional Comments: (Attach additional pages if needed)
Cc: Fire Department Page 4 of 4
CITY OF ARLINGTON
238 N. OLYMPIC AVE -ARLINGTON, WA. 98223
` PHONE; (360) 403-3551
BUILDING PERMIT
Address:2233 State Route 530 Permit#:1148
Parcel#:31050800200800 Valuation: 1800 00
OWNER APPLICANT CONTRACTOR
Name:BIR SINGH ENTERPRISES INC Name:Suburban Propane Name:SUBURBAN PROPANE
Address:4414 220TH ST SE Address:12820 34th Ave NE Address: 12820 34TH AVE NE
City,State Zip:BOTHELL,WA 98021 City,State Zip:Marysville,WA 98271 City,State Zip:MARYSVILLE,WA 98270
Phone: Phone:360-661-4105 Phone:360-659-1251
MECHANICAL CONTRACTOR PLUMBING CONTRACTOR
Name:SUBURBAN PROPANE Name:
Address: 12820 34TH AVE NE Address:
City,State,Zip:MARYSVILLE,WA 98270 City,State,Zip:
Phone:360-659-1251 Phone:
LIC#: EXP: LIC#: EXP:
JOB DESCRIPTION
PERMIT TYPE: Commercial Mechanical CODE YEAR: 2015
STORIES: 0 CONST.TYPE:
DWELLING UNITS: 0 OCC GROUP:
BUILDINGS: 0 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. IBCI IOARC110.
SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City gton m st be reported on your sales tax return form
and coded City of Arlington#3101.
Signature Print Name Date Released f to
CONDITIONS
Approved as submitted. An Labor and Industries inspection is required prior to a final mechanical
inspection.
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
9/23/2016 Mechanical Fee(Enter Fixture Fee) $25.00
9/23/2016 Mechanical Permit Base Fee $25.00
9/23/2016 Mechanical Plan Review Fee $200.00
Total Due: $250.00
Total Payment: $0 00
Balance Due: $250.00
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
250 gallon ASME LP tank 500 gallon ASME LP ,
used for store heat. Dispenser with lockable
NNW Q cabinet, motor and
pump.
25' from tank to coffee shack
ARCO AMPM—2233 SR 530, Arlington WA 98223
• Change-out existing Amerigas 500 gallon LP dispenser with cabinet, pump and motor with Suburban Propane 500 gallon LP dispenser with cabinet, pump
and motor.
o Use existing electrical in rigid explosion proof conduit with seal offs.
o Wire LP Emergency shutoff into station's main emergency shutoff for all pumps.
• Change-out existing Amerigas 250 gallon LP tank used for store heat with Suburban Propane 250 gallon LP tank to be used for store heat.
o Use existing underground and riser to connect to tank.
• Crash protection
o Each tank has existing required bollards.
a
• e ' ■
PROPAN
2-99
ARC
AMPM 1 Arlington WA 9.
Swap-out above Amerigas 500 gallon LP dispenser with cabinet, pump and motor with the below Suburban Propane 500 gallon LP dispenser with cabinet, pump
• motor.
7('Z�
PERMITTED WITHIN 50 FEET
Propane NO SMOKING OR OPEN FLAME J&�
I J
t
i
1
ARCO AMPM —2233 SR 530, Arlington WA 98223
• Change-out existing Amerigas 250 gallon LP tank used for store heat with same size Suburban Propane 250 gallon LP tank to be used for store heat.
o Use existing underground and riser to connect to tank.
f
WA-530 NE
A• • 1 Arlington WA 98223
250 gallon ASME LP tank
used for store heat. 500 gallon ASME LP
Dispenser with
lockable cabinet,
,t +
_ motor and pump.
roll
rg __ .Apia?cI-
ice., �� 'L• rt; -'�
ARCO AMPM—2233 SR 530, Arlington WA 98223
CITY OF ARLINGTON
' 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223
\ _ , PHONE; (360)403-3551
BUILDING PERMIT
Address:2233 State Route 530 Permit#:1148
Parcel#:31050800200800 Valuation: 1800.00
OWNER APPLICANT CONTRACTOR
Name:BIR SINGH ENTERPRISES INC Name:Suburban Propane Name:SUBURBAN PROPANE
Address:4414 220TH ST SE Address:12820 34th Ave NE Address: 12820 34TH AVE NE
City,State Zip:BOTHELL,WA 98021 City,State Zip:Marysville,WA 98271 City,State Zip:MARYSVILLE,WA 98270
Phone: Phone:360-661-4105 Phone:360-659-1251
MECHANICAL CONTRACTOR PLUMBING CONTRACTOR
Name:SUBURBAN PROPANE Name:
Address: 12820 34TH AVE NE Address:
City,State,Zip:MARYSVILLE,WA 98270 City,State,Zip:
Phone:360-659-1251 Phone:
LIC#: EXP: LIC#: EXP:
JOB DESCRIPTION
PERMIT TYPE: Commercial Mechanical CODE YEAR: 2015
STORIES: 0 CONST.TYPE:
DWELLING UNITS: 0 OCC GROUP:
BUILDINGS: 0 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. IBC 110/IRC110.
SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City 9FIAton m st be reported on your sales tax return form
and coded City of Arlington#3101.
Signature Print Name Date Released Ate
CONDITIONS
Approved as submitted. An Labor and Industries inspection is required prior to a final mechanical
inspection.
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
9/23/2016 Mechanical Fee(Enter Fixture Fee) $25 00
9/23/2016 Mechanical Permit Base Fee $25.00
9/23/2016 Mechanical Plan Review Fee $200.00
Total Due: $250.00
Total Payment: $0.00
Balance Due: $250.00
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
CITY OF ARLINGTON
lam238 N. OLYMPIC AVE-ARLINGTON, WA.98223
PHONE; (360)403-3551
BUILDING PERMIT
Address:2233 State Route 530 Permit#:1148
Parcel#:31050800200800 Valuation: 1800,00
OWNER APPLICANT CONTRACTOR
Natne:B1R SINGH ENTERPRISES INC Name:Suburhan Propane Name:SUBURBAN PROPANE
{I Address:4414 220TH ST SE Address:12821)341h Ave NF Address: 12820 34T"AVE NE
City,state Zip:BOTHELL,WA 98021 City,State Zip:Marysville,WA 98271 City,State Z,ip:MARYSVILLE,WA 98 70
Phone: Phone-360-661-4105 Phune:360-b59-1251
MECHANICAL CONTRACTOR PLUMBING CONTRACTOR
Nance:SUBURBAN PROPAN! "'In,
Address: 12820 34TH AVE NE Address:
City,State,Zip:MARYSVILLE.WA 98270 City,State,Zip:
Phone:360-659-1251 Phone:
I.IC#: EXP:
I.IC#: FXP;
JOB DESCRIPTION
PERMITTYPE: Commercial Mechanical CODE YEAR: 2015
f S'I'ORIIiS: 0 CONST.TYPE:
1 DWELLING UNITS: 0 OCCGROUP:
13UILDINGS: 0 OCC LOAD:
PERMIT APPROVAL
A(iREfi TO COMPLY WITH ciTy AND STATIi LAWS REOULAI ING CONST KULTION AND IN 1 )1NG TI1F WORK AUTPORt%Gf
THEREBY;NO PERSON WILL BE EMPLOYED IN VIOLATION OF TI IE LABOR CODL OF TI IE STATE:OF WASHING'FON RE1 A`1 111610
WORKMEN'S COMPFNSATION INSURANCE'AND RCW 18,27.
THIS APPLICATION IS NOT A PERMIT UNTIL SIC NFI)BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL,FEES ARE AIL).
I I'IS UNLAWFUL r Sli OR OCCUPY A BUILDING OR S'IRUC•'I'URL UNTIL.A FINAL INSPECTION I IAS RHFN MADE AND APPROVAL OR
ACEI '11•ICAt'L'i t CUPANCS'HASBEENCRANTED. IUC110/IRC'I10.
I• '•S s lax relating to construction and construction materials in the City @ton m sl he reported on your sales Lox cu,rn litmt
and c ed C•ly of ingl 3101, h000,
/`
Signalun: Print Name Date Relkascd Ic
CONDITIONS
Approved as submitted. A*Labor and Industries inspection is required prior to a final mechan cal
inspection.
I HIS PHRMIT AUTHORIZS ONLY I'HLi WORK NOTED.THIS PERMITCOVERS WORK TO BE DONE ON PRIVA IF PROPERTI'ONLY iNY
C'ONSTRUCNON ON THE PUBLIC DOMAIN(C'URLIS,SII)F(WALKS,DRIVEWAYS,MARQUEES,I-1'C.J WILL REQUIRE SP.PARATEPERMI SI(IN,
PERMIT FEES
Data Description F 9 Amount
9/2312016 Mechanical Fee(Enter Fixture Fee) S25.00
9/23/2016 Mechanical Permit Base Fee $25.00
9/23/2016 Mechanical Plan Review Fee $200,00
Total Due: S250,00
'total Payment: S0,00
Balance Due: S250.00
CALL FOR INSPECTIONS
BUILDING(360)403-3417
When calling for an inspection please leave the following information:
ro
Permit Information
Date 9/13/2016
Permit Number 1148
Project Name Arco
Applicant Name Suburban Propane
Applicant Address 12820 34th Ave NE
City, State,Zip Marysville,WA 98271
Contact Wayne Meek
Phone 360-661-4105
Email wmeek@suburbanepropane.com
Permit Type Commercial Mechanical
Site Address 2233 State Route 530
Valuation 1800.00
Status Applied
Permit Issued
Permit Expires
Square Feet 0
Type of Construction/Occupancy Load
Number of Stories 0
Proposed Use Replace existing propane tanks with Suburban Propane LP tanks
Assigned To Kristin Foster
Property Information Owner Information
Parcel#:31050800200800 BIR SINGH ENTERPRISES INC
BIR SINGH ENTERPRISES INC 4414 220TH ST SE
2233 STATE ROUTE 530 NE BOTHELL,WA 98021
Contractors
Contractor Name Primary Contact Phone Email Contractor Type License License#
SUBURBAN PROPANE 360-659-1251 1 11CONTRACTOR
Notes
Date Note
9/14/2016 Need out of city license prior to issuing.KF
Uploaded Files Upload File
Date File Uploaded B
9/14/2016 11:00:37 AM 11148 Plans-Des cn tion of P pct�df Foster,Kristin
9/14/2016 11:00:37 AM 1148 Application pdf 1=Oster.Kristin �{
AN
I
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CL MMERCIAL MECV-iNICAL
• 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 DRAWINGS AND ALL
OTHER INFORMATION OUTLINED IN THE MECHANICAL PERMIT SUBMITTAL REQUIREMENTS, IF APPLICABLE.
Type of Permit: New Installation 0 Replacement ❑ Alteration
Project Address: 2233 SR 530 NE, Arlington WA 98223 Parcel#: 310508-002-008-00
Replace existing propane tanks with ubu an Propane
Project Description:LP tanks. Valuation:
1,800.00
Owner:ARLINGTON 1-5 ARCO Phone#:360-652-8888
Address: 2146 Clover Ct City: Mukilteo State:WA Zip:98275
Email Address: wmeek@suburbanpropane.com
Singh
Contact Person: Phone#: 360-652-8888
Address:2233 SR 530 NE City.Arlington State: WA Zip: 98223
Email Address:wmeek@suburbanpropane.com
Contractor Name:Suburban Propane Phone#: 360-661-4105
Contractor Address: 12820 34th Ave NE City:Marysville State:WA Zip:98271
Email:wmeek@suburbanpropane.com Wayne Meek
_T _ Contact Person:
Contractor License Number: 601690470 Expiration: 02/28/2017
Please indicate type of number of appliances:
FURNACE CONDENSING UNIT GAS PIPING OUTLET
BOILER HEAT PUMP(multi-split) UNIT HEATER
CHILLER HEAT PUMP(mini-split) PAINT BOOTH
COOLER HEAT PUMP(other) TYPE I HOOD
AC(air cooled) HEAT REJECTION EQUIP TYPE II HOOD
AC(water cooled) VENTILATION SYSTEM AST 2
AC(evaporator) PACKAGED UNIT UST
AC(VRF) DRYER OTHER
I 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 acc:- " ")e laws, rules and regulation of the State of Washington.
Applicants Signature: Date 09/13/2016
Applicants Printed Name: Wayne E Meek
I FOR STAFF USE ONLY - eive
Permit# ;A�dB Amount Received Receipt# Date Received
6/16LP Page 1 of 1
V"t
, A
OPERATING
PERMIT APPLICATION
Department of Community& Economic Development
City of Arlington- 18204 591h Ave Nh;-Arlington.WA 98223-Phone(360)403-3551
Part I
Applicant/Building Information
Applicant's Name: I
Applicant's Address: 2 3 3 S
Contact Person: 6QYAJI� Telephone:
Address of Premises for which Operating Permit is requested:
Ejj Same as above ❑ Other(specify):
Tax Parcel ID#: '31 p S -pCi�.Dll�—o� Current Occupancy Class:
Part II
Type of Operating Permit
An Operating Permit is required to conduct any activity or to use any class of building listed below. Rlease
indicate the type(s) of Operating Permit(s) requested by checking each applicable box. (If you requir
assistance, or would like more information, contact the City of Arlington Building Department at 36( -403-
3551.)
10Manufacturing, storing or handling hazardous materials in quantities exceeding those listed in the Fire
Code (see Appendix A.) Identify the materials and quantities and describe the manner in which the
/materials will be manufactured, stored or handled (attach additional sheets if necessary):
Ag�,�Ir ppr
Revised 4/1/08
Page I of 4 Received
UP 21 2016
fl Hb
Part II(cont'd)
2Conducting a hazardous process or activity, including. but not limited to, any commercial or industrial
operation which produces combustible dust as a byproduct, fruit and crop ripening,waste handling, spray
operations, and high-piled storage (see Appendix B.) Describe the rocess(es)or activity(ies)to be
conducted (attach additional sheets if necessary): (� e
wQ
t V` IA—
�A
❑ Use of pyrotechnic devices in assembly occupancies(see Appendix C.) Describe the devices to a used
and type of event(attach additional sheets if necessary):
[/Aboveground Storage Tank (AST) (see Appendix D)
❑ Removal ❑ Decommissioning ❑ Temporary tank closure Plolanges in service
❑ Permanent tank closure
Brief description: 16&6rg i. w L_7 2; &
❑ Underground Storage Tank(UST) (see Appendix D)
❑ Removal ❑ Decommissioning ❑ Temporary tank closure ❑ Changes in service
❑ Permanent tank closure
Brief description:
❑ Temporary Membrane Structures, including tents and canopies (see Appendix E.) Brief descripti n of
structure and use:
Cc: Fire Department Page 2 of 4
Part II(conVd)
❑ Special Event Operating Permit-An Operating Permit is required for any special event that takes
place within an occupied building, or an outdoor mass gathering,which is outside the scope of he
permitted use(see Appendix F.) Brief description of type of gathering proposed:
Part III
Premises/Building Information
1. Date of last inspection of Premises:
2. Has a Certificate of Occupancy been issued for the premises? 21"
Yes ❑No
Type: RTIPermanent ❑ Temporary Date of Issuance:
3. Are there currently any open Building Permits associated with the premises? ❑ Yes ONo
If yes, please describe (attach additional sheets if necessary):
4. Additional Comments:
SIGNATURE OF APPLICANT
herby certify tt the foregoing in ation (and all information in attached sheets, if any) is true ai d
complete.
S nature o Applicant or Authorized Representatives Signature AMC
' � e
Name and Title(if applicable) of person signing Application (Please print)
Cc: Fire Department Page 3 of 4
Part IV
To be completed by the City ofArlington Building Department
Inspection Required: ❑ Yes ❑No
Inspections Performed: ❑ Yes ❑No Date of Inspection:
Tests or Reports required verifying compliance? ❑ Yes ❑No
If YES, have Tests or Reports been received? ❑ Yes ❑No
Application(s) Approved: ❑ Yes ❑ No
Operating Permit Issued by:
Date Operating Permit Issued: Date Operating Permit Expires:
Type/Description of Operating Permit:
Conditions of Operating Permit (list conditions here AND in the space provided in the Operating Per it):
Additional Comments: (Attach additional pages if needed)_
Cc: Fire Department Page 4 of 4
9/14/2016 SUBURBAN PROPANE LP
(Search L&I
; Iml tl••II,
S�lFety&Health Clo-xinns&Insuranfl@; Alorkplace004 Rig(rfi. �rJ;;s� i_.;�cns,;inra
Washington State Department of
" Labor & Industries
SUBURBAN PROPANE LP
Owner or tradesperson TAX DEPT
PO BOX 206
Principals WHIPPANY,NJ 07981-0206
DUNN,MICHAEL JOSEPH 973-503-9373
JR, PARTNER/MEMBER
STIVALA, MICHAEL
ANTHONY, PARTNER/MEMBER
ABEL, PAUL EDWARD, PARTNER/MEMBER
Dante, ElmerJ, PARTNER/MEMBER
ALEXANDER, MARK
A, PARTNER/MEMBER
(End:04/18/2011)
QUADRINO, SALVATORE
M, PARTNER/MEMBER
(End:04/18/2011)
HOEPPER,CHARLES
T,PARTNER/MEMBER
(End:04/18/2011)
FEHELEY, DAVID R,PARTNER/MEMBER
(End:04/18/2011)
HARDIN, STAMEY W,PARTNER/MEMBER
(End:04/18/2011)
MCLVER, KEVIN T,PARTNER/MEMBER
(End:04/18/2011)
NEY, RICHARD J, PARTNER/MEMBER
(End: 04/18/2011)
NUNAN,THOMAS A,PARTNER/MEMBER
(End:04/18/2011)
REILLY,JOHN H, PARTNER/MEMBER
(End:04/18/2011)
Doing business as
SUBURBAN PROPANE LP
WA UBI No. Business type
601 690 470 Limited Liability Company
Governing persons
ANTHONY
M
SIMONOWICZ
CHARLES T HEOPPER;
DAVID R FEHELEY;
GLENN STEC;
JOHN H REILLY;
KENDALL L RHINE;
KEVIN T MCIVER;
MARK A ALEXANDER;
N SURBURBAN PROPANE GP;
N SURBURBAN PROPANE PA;
RAYMOND J RIGUTTO; HOP +e
RICHARD J NEY: p y„ rrt�rve
https://secure.I ni.wa.gov/verify/D etai i.aspx?UBI=601690470&LIC=SU BU R PLO44DA&SAW= 1/4
9/14/2016 SUBURBAN PROPANE LP
SALVATORE M QUADRINO;
STAMEY W HARDIN;
STEVEN W WELLS;
THOMAS A NUNAN;
License
Verify the contractor's active registration/license/certification(depending on trade)and any past violations.
Construction Contractor Active.
Meets current requirements.
License specialties
GENERAL
License no.
SUBURPLO44DA
Effective—expiration
03/01/1996—03/16/2017
Bond
RLI INS CO $12,000.00
Bond account no.
CMS213272
Received by L&I Effective date
03/11/2003 03/01/2003
Expiration date
Until Canceled
Insurance
Ace American Insurance Company $1,000,000.00
Policy no.
HDOG27398170
Received by L&I Effective date
09/30/2015 10/01/2015
Expiration date
10101/2016
Insurance history
Savings
............... ....
No savings accounts during the previous 6 year period.
Lawsuits against the bond or savings
No lawsuits against the bond or savings accounts during the previous 6 year period.
L&I Tax debts
No L&I tax debts are recorded for this contractor license during the previous 6 year period,but some debts
may be recorded by other agencies.
License Violations
Infraction no.
EWINP00643 Satisfied
Issue date RCW/WAC
02/08/2016 19.28.101 RCW
Violation city Violation amount
BATTLEGROUND $250.00
Type of violation
ELECTRICAL CITATION
Description
Failing to get an inspection or obtain a valid
electrical/telecommunications work permit or
post a provisional electrical work permit prior
to beginning the electrical/telecommunication
installation or alteration as referenced in WAC
296-46B-901.
Infraction no.
EWINP00645 Satisfied
Issue date RCW/WAC
02/08/2016 19.28.041 RCW
Violation city Violation amount Help us inlpro've
hfps://secure.Ini.wa.gov/verify/Detail.aspx?UBI=601690470&LIC=SUBURPLO44DA&SAW= 214
i�
9/14/2016 SUBURBAN PROPANE LP
BATTLEGROUND $500.00
Type of violation
ELECTRICAL CITATION
Description
Offering to perform,submitting a bid for,
advertising,installing or maintaining cables,
conductors or equipment that convey or
utilize electrical current without having a
valid electrical contractor license.
Infraction no.
EWINP00646 Satisfied
Issue date RCW/WAC
02/08/2016 19.28.271 RCW
Violation city Violation amount
BATTLEGROUND $250.00
Type of violation
ELECTRICAL CITATION
Description
Employing an individual for the purposes of
chapter 19.28 RCW who does not possess a
valid certificate of competency or training
certificate to do electrical work.
Workers' comp
Do you know if the business has employees?If so,verify the business is up-to-date on workers'comp premiums.
L&I Account ID Account is current.
905,532-00
Doing business as
SUBURBAN PROPANE L P
Estimated workers reported
Quarter 2 of Year 2016"76 to 100 Workers"
L&I account representative
T2/DAN STRATE(360)902-4635-Email:STRE235@ni.wa.gov
Workplace safety and health
Check for any past safety and health violations found on jobsites this business was responsible for.
Inspection results date
12/11/2015 No violations
Inspection no.
317937553
Location
2317 N Machias Rd
Lake Stevens,WA 98258
Inspection results date
07/10/2013 No violations
Inspection no.
316835172
Location
7030 Tacoma Mail Blvd Ste 200
Tacoma,WA 98409
Inspection results date
11/23/2010 No violations
Inspection no.
314599721
Location
hfps://secure.I ni.wa.govtverify/D etai i.aspx?U BI=601690470&LIC=SU BU R PLO44DA&SAW= 3/4
9/14/2016 SUBURBAN PROPANE LP
3515 Chico Way NW !
Bremerton,WA 98312
J Washington Stale Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington.
https://secure.ini.wa.gov/verify/Detai i.aspx?U BI=601690470&LIC=SU BU RPL044DA&SAW= 4/4
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Permit#: 1148
Permit Date: 09/13/16
Permit Type: COMMERCIAL MECHANICAL
Project Name: Arco
Applicant Name: Suburban Propane
Applicant Address: 12820 34th Ave NE
Applicant, City, State, Zip: Marysville,WA 98271
Contact: Wayne Meek
Phone: 360-661-4105
Email: wmeek@suburbanepropane.com
Scope of Work: Replace existing propane tanks with Suburban Propane LP tanks
Valuation: 1800.00
Square Feet: 0
Number of Stories: 0
Construction Type:
Occupancy Group:
ID Code:
Permit Issued: 09/23/2016
Permit Expires:
Form Permit Type:
Status: LASERFICHE
Assigned To: Kristin Foster
Property
Parcel# Address Legal Description Owner Name Owner Phone Zoning
31050800200800 2233 STATE ROUTE 530 BIR SINGH 549 Other Retail
NE ENTERPRISES INC Trade-Food NEC
Contractors
Contractor Primary Contact Phone Address Contractor Type License License
SUBURBAN PROPANE Wayne Meek 360-659-1251 12820 34TH AVE CONSTRUCTION
NE CONTRACTOR
Inspections
Date Inspection Type Description Scheduled Date Completed Date Inspector Status
10/28/2016 Inspection 10/28/2016 10/28/2016 BUILDING Approved
Plan Reviews
Date Review Type Description Assigned To Review Status
COMMERCIAL Will require L&I inspection and final mechanical
09/14/2016 BUILDING
MECHANICAL inspection.KO.
Fees
Fee Description Notes Amount
Mechanical Fee(Enter Fixture Fee) $25.00
Mechanical Base Permit Fee $25.00
Mechanical Commercial Plan Review Table 4-1 $200.00
Total $250.00
Attached Letters
Date Letter Description
09/23/2016 Building Permit
Payments
Date Paid By Description Payment Type Accepted By Amount
09/28/2016 Wayne Meek 61590623 cc $250.00
Outstanding Balance $0.00
Notes
Date Note Created By:
09/28/2016 Out of city has been issued.KF Kristin Foster
09/14/2016 Need out of city license prior to issuing.KF Kristin Foster
Uploaded Files
Date File Name
09/29/2016 1867275-1148 Issued Permit.pdf
09/21/2016 1854589-1148 Operating PermitApplication.pdf
09/14/2016 1841659-1148 Apnlication.pdf
09/14/2016 1841660-1148 Plans-Description of Project.pdf
Date: 03/11/2026
Permit#: 1148
Permit Date: 09/13/2016
Review Date: 09/14/2016
Permit Type: COMMERCIAL MECHANICAL
Review Type: COMMERCIAL MECHANICAL
Target Date: 09/28/2016
Scheduled Time: 00:00
Completed Date: 09/22/2016
Description: Will require L&I inspection and final mechanical inspection.KO.
Review Status:
Assigned To: BUILDING
Time In: 00:00
Time Out: 00:00
Hours: 0.0
Property Information
Parcel#: 31050800200800 BIR SINGH ENTERPRISES INC
BIR SINGH ENTERPRISES INC 4414 220TH ST SE
2233 STATE ROUTE 530 NE BOTHELL, WA 98021
Zoning: 549 Other Retail Trade - Food
NECLot: Block: