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HomeMy WebLinkAbout17504 OSPREY RD_BLD1217_2026 RESIDENTIAL MECHANICAL PERMIT APPLICATION t�N Department of Community & Economic Development City of Arlington • 18204 59th Ave NE • Arlington, WA 98223 • Phone (360) 403-3551 THIS APPLICATION IS TO BE USED WHEN APPLYING FOR NEW MECHANICAL INSTALLATION AND OR GAS PIPING FOR EXISTING RESIDENCES. PLEASE FILL OUT ALL PAGES OF THIS APPLICATION AND INCLUDE ALL INFORMATION. Project Address: 17504 OSPREY RD ARLINGTON , WA 98223 Project Description:LIKE IN KIND FURNACE REPLACEMENT Owner: LINDA CARBAJAL Address. 17504 OSPREY RD City. ARLINGTON State.WA Zip Code: 98223 Phone. 425-328-5877 Email:INFO@BLUEFLAMECOMFORT.COM Applicant: KAILANA MONIZ Address: 7116 220TH ST SW#1 City: MOUNTLAKE State.WA Zip Code: 98043 Phone. 425-771-7139 Email: INFO@BLUEFLAMECOMFORT.COM CONTRACTOR INFORMATION Contractor Name:BLUE FLAME HEATING AND AIR Address: 7116 220TH STSW#1 City: MOUNTLAKE State.WA Zip Code: 98043 License Number. BLUEFFH865JB Expiration: 04/02/18 Phone: 425-771-7139 Email:INFO@BLUEFLAMECOMFORT.COM STAFF USE ONLY Permit #: Accepted by: Date: 6/16LP Page 1 of 2 Y. RESIDENTIAL MECHANICAL PERMIT APPLICATION SING Department of Community& Economic Development City of Arlington • 18204 59th Ave NE• Arlington, WA 98223• Phone(360) 403-3551 SELECT ALL PROPOSED APPLIANCES Furnace (80+) Model #R802V AFUE ❑ Heat Pump Model # AFUE HSPE ❑ AC Unit Model # SEER ❑ Freestanding Stove ❑ Fire Place Insert ❑ Outdoor BBQ ❑ Gas Piping ❑ Solid-Fuel Appliance ❑ Other Gas Piping Information Not Applicable: [El Pipe Material: Pipe Size: Distance from Meter to Furthest Appliance: Total BTU's of all Appliances: • 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 Applicant Signature: Date: 11/18/2016 Applicant Printed Name: KAILANA MONIZ I hereby certify that the above information is correct and that the construction, installation for the above mentioned property will be in accordance with the applicable laws of the City of Arlington and the State of Washington. 6/16LP Page 2 of 2 ' CITY OF ARLINGTON 238 N. OLYMPIC AVE-ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:17504 Osprey Road Permit#:1217 Parcel#:00809200002200 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:CARBAJAL LINDA L Name:Blue Flame Heating and Air Name:BLUE FLAME HEATING AND AIR Address: 17504 OSPREY RD Address:7116 220th Street SW,#1 Address:7116 220 ST SW City,State Zip:ARLINGTON,WA 98223-5953 City,State Zip:Mount Lake Terrace,WA 98043 City,State Zip:MOUNTLK TERRACE,WA 98043 Phone: Phone:425-771-7139 Phone:425-771-7139 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name:BLUE FLAME HEATING AND AIR Name: Address:7116 220 ST S W Address: City,State,Zip:MOUNTLK TERRACE,WA 98043 City,State,Zip: Phone:425-771-7139 Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Residential Mechanical 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. IBC1 10/IRCI 10. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of Arlin rted on your sales tax return form nd'cod rlington#310 VA i (1� ignature Print Name Date Released By Date CONDITIONS Approved as submitted. Duct Testing is required per the 2015 Washington State Energy Code R402.4.1.2 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 11/21/2016 Furnace $25.00 11/21/2016 Mechanical Permit Base Fee $25.00 Total Due: S50.00 Total Payment: $50.00 Balance Due: $0.00 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 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 ` PHONE; (360)403-3551 BUILDING PERMIT Address:17504 Osprey Road Permit#:1217 Parcel#:00809200002200 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:CARBAJAL LINDA L Name:Blue Flame Heating and Air Name:BLUE FLAME HEATING AND AIR Address: 17504 OSPREY RD Address:7116 220th Street SW,#1 Address:7116 220 ST SW City,State Zip:ARLINGTON,WA 98223-5953 City,State Zip:Mount Lake Terrace,WA 98043 City,State Zip:MOUNTLK TERRACE,WA 98043 Phone: Phone:425-771-7139 Phone:425-771-7139 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name:BLUE FLAME HEATING AND AIR Name: Address:7116 220 ST SW Address: City,State,Zip:MOUNTLK TERRACE,WA 98043 City,State,Zip: Phone:425-771-7139 Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Residential Mechanical CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: I OCC GROUP. BUILDINGS: OCC LOAD: A 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 IOARC110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of Arlin t rted on your sales tax return form and coded City of Arlington#3101. Signature Print Name Date Released By Date CONDITIONS Approved as submitted. Duct Testing is required per the 2015 Washington State Energy Code R402.4.1.2 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 11/21/2016 Furnace $25.00 11/21/2016 Mechanical Permit Base Fee $25.00 Total Due: $50.00 Total Payment: $50 00 Balance Due: $0.00 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 i i A=` CITY OF ARLINGTON 238 N. OLYMPIC AVE-ARLINGTON,WA. 98223 PHONE;(360)403-3551 BUILDING PERMIT Address:17504 Osprey Road Permit#:1217 Parcel#:00809200002200 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:CARBAJAL LINDA L Name:Blue Flame Heating and Air Name:BLUE FLAME HEATING AND Alit Address: 17504 OSPREY RD Address:71 l6 220th Street SW,#I Address:7116 220 ST SW City,State Zip:ARLINGTON,WA 98223-5953 City,State Zip:Mount Lake Terrace,WA 98043 City,Stale Zip:MOUNT'LK TERRACE,WA 98043 Phone: Phone:425-771-7139 Phone:425-771-7139 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name:BLUE FLAME HEATING AND AIR Name: Address:7116 220 ST S W Address: City,State,Zip:MOUNTLK TERRACE,WA 98043 City,State,Zip: Phone:425-771-7139 Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Residential Mechanical CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: OCC OROUP. BUILDINGS: OCC LOAD: PERMIT APPROVAL 1 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/IRCI 10. 1, Sales lax relating to construction and construction materials in the City of Arlin rted on your sales tax return form nd'cod y rlington#3I0 n , Ignature Print Name Date Released By Date CONDITIONS Approved as submitted. Duct Testing is required per the 2015 Washington State Energy Code R402.4.1.2 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 11/21/2016 Furnace $25 00 11/21/2016 Mechanical Permit Base Fee $25.00 Total Due: $50.00 Total Payment: $50.00 Balance Due: Sp,00 CALL FOR INSPECTIONS BUILDING(360)403.3417 When calling for an inspection please leave the following information: Permit Number,Type orinspection being requested,and whether you prefer morning or afternoon CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:17504 Osprey Road Permit#:1217 Parcel#:00809200002200 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:CARBAJAL LINDA L Name:Blue Flame Heating and Air Name:BLUE FLAME HEATING AND AIR Address: 17504 OSPREY RD Address:7116 220th Street SW,#1 Address:7116 220 ST SW City,State Zip:ARLINGTON,WA 98223-5953 City,State Zip:Mount Lake Terrace,WA 98043 City,State Zip:MOUNTLK TERRACE,WA 98043 Phone: Phone:425-771-7139 Phone:425-771-7139 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name:BLUE FLAME HEATING AND AIR Name: Address:7116 220 ST SW Address: City,State,Zip:MOUNTLK TERRACE,WA 98043 City,State,Zip: Phone:425-771-7139 Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Residential Mechanical CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: 1 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. IBC110/IRC110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of Arlin C ortcd on your sales tax return form and coded City of Arlington#3101. .22.110 Signature Print Name Date Released By Date CONDITIONS Approved as submitted. Duct Testing is required per the 2015 Washington State Energy Code R402.4.1.2 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 11/21/2016 Furnace $25.00 11/21/2016 Mechanical Permit Base Fee $25.00 Total Due: $50.00 Total Payment: $50.00 Balance Due: $0.00 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 + " ''� • - - M Permit Information Date 11/18/2016 Permit Number 1217 Project Name Carbajal Applicant Name Blue Flame Heating and Air Applicant Address 7116 220th Street SW,#1 City, State,Zip Mount Lake Terrace,WA 98043 Contact Kailana Moniz Phone 425-771-7139 Email info@blueflamecomfort.com Permit Type Residential Mechanical Site Address 17504 Osprey Road Valuation 0.00 Status Applied Permit Issued Permit Expires Square Feet 0 Type of Construction/Occupancy Load Number of Stories 0 Proposed Use Replace Furnace Assigned To Kristin Foster Property Information Owner Information Parcel#:00809200002200 CARBAJAL LINDA L CARBAJAL LINDA L 17504 OSPREY RD 17504 OSPREY RD ARLINGTON,WA 98223-5953 Contractors Contractor Name Primary Phone Email Contractor License License# Contact Type 13LUE FLAME HEATING RODNEY 425-771- Labor& AND AIR WALKER 7139 nfo@blueflamecomfort.com CONTRACTOR Industries 13LUEFFH865J Fees Fee Description Notes Amount Furnace 322.10.00.0 $25.00 Mechanical Permit Base Feel 322.10.00.Oq $25.00 Total $50.0 Uploaded Files Upload File Date I File IUploaded B 11/18/2016 3:01:35 PM 1217 App cation.pd__f IFoster, Kristin RESIDENTIAL MECHANICAL PERMIT APPLICATION Department of Community& Economic Development City of Arlington • 18204 59th Ave NE• Arlington,WA 98223• Phone(360) 403-3551 THIS APPLICATION IS TO BE USED WHEN APPLYING FOR NEW MECHANICAL INSTALLATION AND OR GAS PIPING FOR EXISTING RESIDENCES. PLEASE FILL OUT ALL PAGES OF THIS APPLICATION AND INCLUDE ALL INFORMATION, Project Address:17504 OSPREY RD ARLINGTON , WA 98223 Project Description:LIKE IN KIND FURNACE REPLACEMENT Owner: LINDA CARBAJAL Address: 17504 OSPREY RD City:ARLINGTON StateWA Zip Code: 98223 Phone: 425-328-5877 Email:INFO@BLUEFLAMECOMFORT.COM Applicant: KAILANA MONIZ Address, 7116 220TH STSW#1 City: MOUNTLAKE State WA Zip Code: 98043 Phone: 425-771-7139 Email: INFO@B LU EFLAMECOMFORT.COM CONTRACTOR INFORMATION Contractor Name:BLUE FLAME HEATING AND AIR Address:7116 220TH STSW#1 City: MOUNTLAKE State WA Zip Code: 98043 License Number:BLUEFFH865JB Expiration: 04/02/18 Phone:425-771-7139 Email:INFO@BLUEFLAMECOMFORT.COM STAFF USE ON Received Permit#: 1211 Accepted by: Date: NOV 18 2016 6/16LP Page 1 of 2 RESIDENTIAL MECHANICAL PERMIT APPLICATION Department of Community& Economic Development City of Arlington • 18204 59th Ave NE• Arlington,WA 98223• Phone(360) 403-3551 SELECT ALL PROPOSED APPLIANCES � Furnace (80+) Model #R802V AFUE ❑ Heat Pump Model # AFUE HSPE_ ❑ AC Unit Model # SEER ❑ Freestanding Stove Q Fire Place Insert ❑ Outdoor BBQ ❑ Gas Piping ( Solid-Fuel Appliance Othcr Gas Piping Information Not Applicable: [ Pipe Material: Pipe Size: Distance from Meter to Furthest Appliance: Total BTU's of all Appliances: • 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 Applicant Signature: ..,_ ,._ .... ....M„w Date 11/18/2016 Applicant Printed Name: KAILANA MONIz I hereby certify that the above information is correct and that the construction, installation for the above mentioned property will be in accordance with the applicable laws of the City of Arlington and the State of Washington. 6/16LP Page 2 of 2 11/18/2016 BLUE FLAME HTG&AIR CNDTNG Learch L&I -1 Lufc if"'I Atc I.&I 3Eak--ty&dealih Clan)s &fosur�+nee Workplace Bights Trades &Licensing A^ Washington State Department of " Labor & Industries BLUE FLAME HTG &AIR CNDTNG Owner or tradesperson 7116 220TH ST SW//1 Principals MOUNTLAKE TERRACE,WA 98043 425-771-7139 CHAISSON, DENNIS J, PARTNER/MEMBER SNOHOMISH County Doing business as BLUE FLAME HTG&AIR CNDTNG WA UBI No. Business type 603 341 089 Limited Liability Company Parent company CHAISSON CONSULTING LLC 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. BLUEFFH865JB Effective—expiration 04/02/2014—04/02/2018 Bond Nationwide Mutual Ins Co $12,000.00 Bond account no. 7900411538 Received by L&I Effective date 04/02/2014 04/02/2014 Expiration date Until Canceled Insurance American Fire&Casualty Co $1,000,000.00 Policy no. BKA57145709 Received by L&I Effective date 04/19/2016 03/17/2016 Expiration date 0 311 7/20 1 7 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. Help us improve https://secure.Ini.wa.gov/verify/Detail.aspx?UBI=603341089&LIC=BLUEFFH865JB&SAW= 1/2 11/18/2016 BLUE FLAME HTG&AIR CNDTNG License Violations X- No license violations during the previous 6 ye.. .,ariod. 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. 289,641-00 Doing business as BLUE FLAME HEATING AND AIR CON Estimated workers reported Quarter 3 of Year 2016"31 to 50 Workers" L&I account representative T2/CHRISTOPHER WASSON(360)902-6331-Email:WASQ235(oni.wa.gov Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. ©Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. Help us improve https://secure.ini.wa.gov/verify/Detail.aspx?U BI=603341089&LIC=BLU EFFH865JB&SAW= 2 2 i i Permit#: 1217 Permit Date: 11/18/16 Permit Type: RESIDENTIAL MECHANICAL Project Name: Carbajal Applicant Name: Blue Flame Heating and Air Applicant Address: 7116 220th Street SW, #I Applicant, City, State, Zip: Mount Lake Terrace,WA 98043 Contact: Kailana Moniz Phone: 425-771-7139 Email: info@blueflamecomfort.com Scope of Work: Replace Furnace Valuation: 0.00 Square Feet: 0 Number of Stories: 0 Construction Type: Occupancy Group: ID Code: Permit Issued: 11/21/2016 Permit Expires: Form Permit Type: Status: LASERFICHE Assigned To: Kristin Foster Property Parcel# Address Legal Description Owner Name Owner Phone Zoning 00809200002200 17504 OSPREY RD CARBAJAL LINDA 111 Single Family L Residence-Detached Contractors Contractor Primary Contact Phone Address Contractor Type License License# BLUE FLAME RODNEY CONSTRUCTION HEATINGANDAIR WALKER 425-771-7139 7116 220 ST SW CONTRACTOR COA 601 837 949 BLUE FLAME RODNEY CONSTRUCTION Labor&BLUEFFH825RM HEATING AND AIR WALKER 425-771-7139 7116 220 ST SW CONTRACTOR Industries Fees Fee Description Notes Amount Forced Air Heat fee per Btu $25.00 Mechanical Base Permit Fee $25.00 Total $50.00 Attached Letters Date Letter Description 11/21/2016 Building Permit Payments Date Paid By Description Payment Type Accepted By Amount 11/20/2016 Kailana Moniz CC Transaction Kristin Foster $50.00 #62368317 Outstanding Balance $0.00 Notes Date Note Created By: 11/21/2016 Emailed permit for signature.KF Kristin Foster Uploaded Files Date File Name 11/21/2016 1959943-1217 Issued Permit.pdf 11/18/2016 1958906-1217 Application.pdf