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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 I I r t 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 1 I I Q E 7 Q a-+ a) C_ L m u L t m v L a1 C � a1 O Q N N ` CO a a) o a > c� 1 � C � 'Q� �''•'1 r O 0 O 1 .�O Y ' L aj C C +m+ C a p- J O C O Y C � fu0 fa tw 7 Ln � L N Ln C _N O. l oa a wc Y oo c o o -- Ln c a a 3 ° 0 _0 c � m O a, , k 'rz vi �° ° �+ +r 1 Q Ln is c on v c a N + 1 � a ° 0 CL0 LA ° Ln O u Q h Lo o C c E CA o 3 O a, ,o ° a, 0 w v LA o E 0= c a, c Y O LA LA Q c' c c o o m O +J co a Lna m — 4+ aJ O LAN CO x p i N _ w4. _ -D a! 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I � � 1. q a1� • r t I a ' J W yd 9 Ln +-I C Q '3 c u ro c O 0- u O Ln O O E � I •lip - •4 a a�i J L W (U G L Ln Q O N O i N O O 00 m v Q O 7 Ul Ln O N O b c _ _ o rm Ln I{ m {iJ t m N _ U 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: