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HomeMy WebLinkAbout7607 W Country Club Dr_BLD1249_2026 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:7607 W Country Club Dr Project Description:Replacing gas furnace like for like Owner: Jack Shouman Address: 7607 W Country Club Dr City:Arlington StateYVA Zip Code: 98223 Phone: 425-330-3288 Email: Applicant: SEE CONTRACTOR Address: City: State: Zip Code: Phone: Email: CONTRACTOR INFORMATION Contractor Name:KINGS HEATING, INC Address:6925 216th St SW, Suite C City Lynnwood State.WA Zip Code: 98036 License Number:KINGSH1044JA Expiration: 03/10/2017 Phone:425-275-5153 Email:MichaelaP@KingsHeating.com STAFF USE ONLY Permit#: Accepted by: Date: 6/16LP Page 1 of 2 RESIDENTIAL MECHANICAL i # PERMIT APPLICATION jNCS4� 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 #PG8MAA048090 AFUE80% Heat Pump Model # AFUE HSPE AC Unit Model # SEER Freestanding Stove U Fire Place Insert ❑ Outdoor BBQ U Gas Piping U Solid-Fuel Appliance Other Gas Piping Information 1 I Irlr•��� 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 su ported/secured every 6 to 8 feet • Proper Combustion air a v ing required for all pilances • A shut-off vat e ij requi d thin 6 eet ap ipnces 6 // Applicant Signature:__ io— Date: 10_b-a-ke Applicant Printed Name: nnnn I r� 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 CITE' OF ARLINGTON 238 N.OLYMPIC AVE-ARLINGTON,WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:7607 W Country Club Dr Permit#.-1249 Parcel#: Valuation:0.00 OWNER APPLICANT CONTRACTOR Name: Name:Kings Heating,Inc. Name:King's Heating,Inc. Address: Address:6925 216th St SW,Suite C Address:6825 216th St SW City,State Zip:, City,State Zip:Lynnwood,WA 98036 City,State Zip:Lynnwood,WA 98036 Phone: Phone:425-275-5153 Phone:425-344-9668 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name:Kings Heating,Inc Name: Address: 6825 216th St SW Address: City,State,Zip:Lynnwood,WA 98036 City,State,Zip: Phone:425-344-9668 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 E OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFIC TE OF CUP CY HAS BEEN GRANTED. IBC 110l1RC 110. SALE. 'A 'sV0"CI Sa s r lating to construction and construction materials in the City of Ano don your sales tax return form and co e C of Ar n to # 10 . Signature Print Name Owd try Date CONDITIONS Approved as submitted.Adhere to model#PG8MAA048090 AFUE 80%.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 12/12/2016 Furnace $25.00 12/12/2016 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 rollowing 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:7607 W Country Club Dr Permit#:1249 Parcel#: Valuation:0.00 OWNER APPLICANT CONTRACTOR Name: Name:King's Heating,Inc. Name:King's Heating,Inc. Address: Address:6925 216th St SW,Suite C Address:6825 216th St SW City,State Zip:, City,State Zip:Lynnwood,WA 98036 City,State Zip:Lynnwood,WA 98036 Phone: Phone:425-275-5153 Phone:425-344-9668 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name:King's Heating,Inc Name: Address: 6825 216th St SW Address: City,State,Zip:Lynnwood,WA 98036 City,State,Zip: Phone:425-344-9668 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. IBC 110/IRC 110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of fino b d on your sales tax return form and coded City of Arlington#3101. Signature Print Name Date RYFeM ffy Date CONDITIONS Approved as submitted. Adhere to model#PG8MAA048090 AFUE 80%. 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 12/12/2016 Furnace $25.00 12/12/2016 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 CITY OF ARLINGTON e 239 N.OLYMPIC AVE-ARLINGTON, WA. 98223 PHONE;(360)403-3551 BUILDING PERMIT Address:7607 W Country Club Dr Permit#:1249 Parcel#: Valuation:0.00 OWNER APPLICANT CONTRACTOR Name: Name:King's Heating,Inc. Name:Kings Heating,Inc. Address: Address:6925 216th St SW,Suite C Address:6825 216th St SW City,State Zip:, City,State Zip:Lynnwood,WA 98036 City,State Z.ip:Lynnwood,WA 98036 Phone: Phone:425-275-5153 Phone:425-344-9668 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name:King's Ileating,Inc Name: Address: 6825 2161h St SW Address: City,State,Zip:Lynnwood,WA 98036 City,State,Zip: Phone:425-344-9668 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 ANTI 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 WAS] INGTON 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 E OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFIC TE OF CUP CY HAS BEEN GRANTED. IBC 1 l0/1RC 110. SALE. A. NOTl : sa lating W construction and construction materials in the City of A n o i A on your Sales tax return form and co C of Ar o n # 10 . 41 7a- ��II I'c •�Z, Ito Signature Print Name Date Ro na J y Date CONDITIONS Approved as submitted.Adhere to model#PG8MAA048090 AFUE 80%.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.)WELL REQUIRE SEPARATE PERMISSION. __ PERMIT FEES Date Description Fee Amount 1 211 21201 6 Furnace $25.00 12/12/2016 Mechanical Permit Base Fee $25.00 Total Due: $50.00 Total Payment: $50.00 Balance Due: $0.00 CALL FOR INSPECTIONS _ BUILT LNG(360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of lnspection being requested,and whether you prefer morning or afternoon i _ 1 CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDIN_ G PERMIT Address:7607 W Country Club Dr Permit#:1249 Parcel#: Valuation:0.00 OWNER APPLICANT CONTRACTOR Name: Name:King's Heating,Inc. Name:King's Heating,Inc. Address: Address:6925 216th St SW,Suite C Address:6825 216th St SW City,State Zip:, City,State Zip:Lynnwood,WA 98036 City,State Zip:Lynnwood,WA 98036 Phone: Phone:425-275-5153 Phone:425-344-9668 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name:King's Heating,Inc Name: Address: 6825 216th St SW Address: City,State,Zip:Lynnwood,WA 98036 City,State,Zip: Phone:425-344-9668 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. IBCI10/IRC110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of A n o it d on your sales tax return form and coded City of Arlington#3101. Signature Print Name Date 1 e d try Date CONDITIONS Approved as submitted. Adhere to model #PG8MAA048090 AFUE 80%. 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 12/12/2016 Furnace $25.00 12/12/2016 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 _ _ � , � in RESIDENTIAL MECHANICAL ♦ s 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:7607 W Country Club Dr Project Description:Rep lacing gas furnace like for like Owner: lack Shouman Address: 7607 W Country Club Dr City:Arlington StateYVA Zip Code: 98223 Phone: 425-330-3288 Email. Applicant: SEE CONTRACTOR Address: City: State: Zip Code: Phone: Email: CONTRACTOR INFORMATION Contractor Narne:KINGS HEATING, INC Address: 6925 216th St SW, Suite C City: Lynnwood StatelNA Zip Code: 98036 License Number:KINGSH1044JA Expiration: 03/10/2017 Phone:425-275-5153 Email:MichaelaP@KingsHeating.com 1 STAFF USE O N L i,O� Received Permit#: I ?j Accepted by: Date: DEC 12 2(m 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 ##PGBMAA048090 AFUE80% Heat Pump Model # AFUE HSPE AC Unit Model# _ SEER Freestanding Stove U Fire Place Insert Outdoor BBQ ❑ Gas Piping Solid-Fuel Appliance ❑ Other Gas Piping Information Not Applicable: f� Pipe Materlal: 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 areduia ported/secured every 6 to 8 feet • Proper Combing required for all ppiiances • A shut-oft valn 6 eet ap inces Applicant Signature: _ _ -_ - _ _ Date---- Applicant Printed Name: 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 12/12/2016 KING'S HEATING INC i�iuiss: i.:�rspq s.au:+' Search L&I \-X!mlr- (help [,'C.&i 3a(ety H(ealtf� Cairns Irs<<rance V'/ork��lare (�Iglrts Trades !.icer�s(ng Washington State Department of Labor & Industries KING'S HEATING INC Owner or tradesperson 6925 216TH ST SW C Principals LYNNWOOD,WA 98036 425-275-5153 POLLARD, GARY B SNOHOMISH County POLLARD, ERIN K Doing business as KING'S HEATING INC WA UBI No. Business type 601 682 595 Corporation Governing persons ERIN KELLY POLLARD GARY BROOKS POLLARD; 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. KINGSH1044JA Effective—expiration 04/01/1996—03/10/2018 Bond CBIC $12,000.00 Bond account no. SA1782 Received by L&I Effective date 03/05/2002 03/07/2002 Expiration date Until Canceled CBIC $12,000.00 Bond account no. SA1782 Received by L&I Effective date 03/05/2002 03/07/2002 Expiration date Until Canceled Insurance American Fire&Casualty Co $1,000,000.00 Help ivi improve https://secure.ini.wa.gav/verify/Detail.aspx?UBI=601682595&LIC=KINGSH1044JA&SAW= 1/2 1 12/12/2016 KING'S HEATING INC Policy no. BKA57560613 Received by L&I Effective date 10/11/2016 08/25/2016 Expiration date 04/01/2017 American Fire&Casualty Co $1,000,000.00 Policy no. BKA155515384 Received by L&I Effective date 03/31/2016 04/01/2015 Expiration date 04/01/2017 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 No license violations during the previous 6 year period. 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 841,812-01 Doing business as KINGS HEATING INC Estimated workers reported Quarter 3 of Year 2016"11 to 20 Workers" L&I account representative T1/NIKKI BUTLER(360)902-d918-Email:BUTQ235@jni.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. I pip us improve https://secure.Ini.wa.gov/verify/Detail.aspx?UBI=601682595&LIC=KINGSH1044JA&SAW= 212 I Permit#: 1249 Permit Date: 12/12/16 Permit Type: RESIDENTIAL MECHANICAL Project Name: Shouman Applicant Name: King's Heating, Inc. Applicant Address: 6925 216th St SW, Suite C Applicant, City, State, Zip: Lynnwood, WA 98036 Contact: Michaela Pollard Phone: 425-275-5153 Email: michaelap@kingsheating.com Scope of Work: Replace Gas Furnace Valuation: 0.00 Square Feet: 0 Number of Stories: 0 Construction Type: Occupancy Group: ID Code: Permit Issued: 12/12/2016 Permit Expires: Form Permit Type: Status: COMPLETE Assigned To: Kristin Foster Property Parcel# Address Legal Description Owner Name Owner Phone Zoning Contractors Contractor Primary Contact Phone Address Contractor Type License License# King's Heating,Inc. Michaela Pollard 425-344-9668 6825 216th St SW CONSTRUCTION Labor&Industries KINGSHI044JA CONTRACTOR 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 12/12/2016 Building Permit Payments Date Paid By Description Payment Type Accepted By Amount 12/12/2016 Erin Pollard 62667255 cc $50.00 Outstanding Balance $0.00 Notes Date Note Created By: 12/12/2016 Model#PGMAA048090 AFUE 80% Kristin Foster Uploaded Files Date File Name 12/12/2016 2006206-1249 Issued Permit.pdf 12/12/2016 2006133-1249 Apnlication.pdf