HomeMy WebLinkAbout330 S Stillaguamish Ave_962027_2026 C I TY OF €kRL_ I NS_F0N
CONSYRUCT I ON PCRM I Y
PERM I Y NO- o 96—a0a?
Owner: CASCADE VALLEY HOSP
Value of Work: $20,000. 00 Tax ID: s3i0i�.t_ �= - +� +hones
Describe Work: INS'TAL.LATIQN OF WIRELESS COMMUNICAi DONS 'TAT INN
Proposed Use; PUBLIC; HOSPITAL
Legal Description:
Job Address; 330 S 9TD'.=_._AGUPM11-3H P? E
Contractor' s Name Type Address License#
H
TOTALS Fee
Permit Fee $0.00
SIGNATURE:
1 TOTAL FEE.... . . .... . . .. . . . $0.00 I HEREBY FY 1-HP
AND EXAMINED THIS APPLICATION AND
PAYMENTS.. ... .. . . . .. .. . ...$0.0 KNOW THE SAME TO BE TRUE AND COR-
RECT LL PROVISIONS OF LAWS AND
TOTAL DUE... .. .. .. ... . . . .. $0.00 ORD! CES GOVERNING THIS INOL. OF
WOR' W .LL BE COMPLY WIT WHETHER
_F ED HEO IN OF El-If
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BUI_DING OFFICIAL
..Et:
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"PARTMENTOF LABOR AND INDUSTRIES
ECE�jVeD', 346
1CFORY-BUILT 1101''SINC 8, CO-AIMERCIAL
STRUCTURES SECTION NAME:
HARRISON SEATTLE: WASHINGTON 98119
(206) 464-5360 14-191L&
U 1 N 1980 SUBMITTED TO I)EPARTMENT 13Y
MANUF'Acrt-REn IN SINGLE:C,.)I""
WaPhingtoo
NOTIFICATION TO LOCAIL-d ENFORCEMENT AGENCY
The FaCtOI*Y-I'Milt Unit Identified Below Requires Completion Work at the Site as Specified.
INSTALLATION LOCATION UNIT IDENTIPWAT ION
)DRESS (:24.5 CA (>S Y-441cy &rp. MFGH'S.SERIAL NO. DEPT.Si*.I1%I NO
,
Ty COUNTY STATE ZIP OCCUPANCY Fiji *Z(j".,I..
JL/i,7-0 A.1 SAID 14 7-
INSTALLATION SITE Is IN [9 CITY DCOUNTY TYPE OF CONSTRUCTION ETA AT SITE'
I _vv ' 4—/17
)FSCRTHE ITEMS REQUIRING COMPLETION %%ORK AT THE: SITE. LIFE SAFETY ITEMS REQUIRE THE JURISDICTION BUILDING OFFICIALS CONCURRENCE SIGNATURE,
14Jr -S a Uq, 7-
Ai
Akic-
)fAnr et r-. 4 tAlIF—S
WSignat ',awi!$.nkcwrcr Date
rz
or Department use: Recv'd.... ... ...... ...... .....By.....&5..................File..... ...........Fee:................................
......... .......
,EA-TX, TO: ..COW.......#4"....4.7. ............... Date
)1'11-TX, TO: ------------------------------------- T)ntp
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S
A1tI.I VTOM GENERAL HOSPITAL
INTROOUCTI011
SITE
The site is "T" shaped* being 403.26' on the north and 411.15'
on the West. The south has a 75x170' extension to Highlands
Ave., and 302' on the east side fronting Stillaguaaish Ave.
The subject property is bounded on the north by residential,
on the east by scattered residence and agriculture, on the
south by residential, and on the vest by residential and
unimproved land. The site is level and planted in grass with
the exception of the west side,
and the southerly 75x170' also having aa slope;
s a downward slope,
overgrown with trees. There is a 107x153' parkinggareaaonathe
south side of the building, with a 8x96' landscaped island
where the flag pole is located. To the rear is a 60x130'
Paved parking area for the employees. Utilities consist of
city water and sewers which are connected.
Area Computations
302.00x 105.d 59,131
75.00z 411.2 30,840
135.56z 411.2 55,742
75.00z 170.0 12. 750
6
158,4630'
158,463 / 43,560 - 3.6 acres
ROTI: The area computation has been made from the dissensions given
on Sheet 1 of Architect's plans dated March 19, 1957.
PARTMENT OF LABOR AND INDUSTRII -) VED DATE:
r7ORY RECEI
i [ 6 Coa � ERCIAL ;
STRUCTURES
SECTION NA.NIE:
V. HARRISON SEATTLE, WASHINGTON 98119 206) 464-5300 FEBF 5 19$1 M B E /�'le�o!-� ��+ .zn✓e
SUBMITTED TO DEPARTMENT BY
Self Y �UI�d ( 14 Be. SIANUFACWHER IN SINGLE COPY
NOTIFICATION TO FOCAL ENFORCEMENT ENT AGENCY
The Factory-Built Unit Identified Below Requires Completion Work at the Site as Specified.
INSTALLATION LOCATION UNIT IDENTIFICATION
MF-GR'S.SERIAL NO. DEPT.SERIAL NO.
Y COUNTY STATE 'LIP OCCUPANCY FIRE ZONE
�. r i o o0+f sN (u04. A a3
TYPE OF CONSTRUCTION ETA AT SITE:
cSTAi,LAT10N SITE 1S IN X CITY ❑ COUNTY
SCRIRF7 ITEMS REQUIRING COMPLETION WORK AT THE SITE. LIFE SAFETY ITEMS REQUIRE THE JURISDICTION BUILDING OFFICIALS CONCURRENCE SIGNATURE,.
� y �
-;;n oAtQ--
I
- 1
St to �lUanufac re Date
or Department use: Recv'd...,2..-..9.'' By.......�..-�. .................File.....J9... .1' .........Fee:. ............................
EA-TX, TO: ...a�/ fI 'o. .rj.. t. !¢. .�tg-1 l ...)9.R-h.-hdY-ma.................... Date //...
TH-TX, TO: ...E/s..sr.. !!.t�lb�...."..-c.r 4!r�.........................................................•----...... Date o7--/b-P,l......
le"
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VCI
Vento Communications, Inc.
January 22, 1996
Ed McMillan
Public Works Director
City of Arlington
Department of Public Works
238 North Olympic Avenue
Arlington WA 98223
RE: Sprint Telecommunications Venture(STV)PCS Facility
Located At: Cascade Valley Hospital
330 South Stillaguamish Avenue Arlington WA 98223
(NORT-001-01)
VIA FACSIMILE 360-435-7944 original to follow
Dear Mr. McMillan:
STV proposes to construct a PCS wireless telecommunications facility on the rooftop of the
above-referenced address. Please see the drawing(not to scale),enclosed.
The proposed base station facility is compact and will consist of three(3) sectors of four(4)
antennas measuring approximately 6' tall, 6"wide and 2"deep,mounted on the rooftop of the
building,with up to five(5) equipment cabinets occupying a 9' x 15' area next to the building.
Also included in the three(3)sectors of antennas are two(2) small Global Positioning System
(GPS) antenna disks(approximately 2"tall x 4"diameter)used for timing purposes. Each base
station facility transmits radio signals in the 1850-1970 Megahertz range, and operates at very
low power levels(less than 200 watts total). These facilities form a web of service enabling the
customer to move throughout the system with a call passed from one base station to another.
The use is defined as"Radio transmitting and satellite signal receiving antenna,"(City of
Arlington Zoning Code 20.07.020 (856 §1 (part), 198D).
For more information on our telecommunications network please see the material enclosed,
which describes this wireless technology and introduces Sprint Telecommunications Venture
(STV).
It is our understanding that the property at the address is zoned"RC 2.5," (Rural Conservation
Zone), the existing use was approved as a conditional use, and the existing C.U.P. allows the
4040 Lake Washington Boulevard,N.E.,Suite 110 Kirkland,WA 98033
Phone: (206)739-9000 Fax: (206)739-9900
1122196 NORT-001-01
ARLLTR.DOC
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VCI
Vento Communications, Inc.
Letter to The City of Arlington
January 22, 1996
Page Two
building to exceed the maximum height of structures in this zone of thirty feet (1985 application
& City of Arlington Municipal Code 20.07.060,(Ord. 856 §1 (part), 1984)). It is our further
understanding that the building, having been approved to exceed the allowed height, causes the
proposed use to be a secondary use to the principal, existing use. Therefore the proposed use
only requires the issuance of a building permit for construction.
Please confirm that we have correctly interpreted the City of Arlington Municipal Code and the
1985 Conditional Use Permit for the existing use,regarding the designation of zone, definition
and allowance of secondary use, and description of approval process, as well as duration of the
C.U.P. for the proposed use, by signing below, faxing(at 206-739-9900),then mailing this letter
to me in the enclosed, self-addressed envelope. In addition, please enclose a photocopy of the
1985 C.U.P. for the existing use. If I can be of further assistance,please call me at 206-739-
9000. My card is enclosed for your convenience.
Sincerely,
VCI, representing Sprint Telecommunications Venture(STV)
Patrick Hewes
Program Manager
Enclosures: drawing(not to scale) of proposal.
Vicinity Map.
PCIA Pamphlet: "What is PCST'
STV Fact Sheet.
Self-addressed, stamped envelope.
I concur that the proposed use is a permitted use according to the above-referenced code and the
1985 thing else is required except the Application for Building Permit.
Signart�uree Date
V vY
Title
4040 Lake Washington Boulevard,N.E.,Suite 110 Kirkland,WA 98033
Phone: (206)739-9000 Fax: (206)739-9900
122/96 NORT-001-01
ARLLTR.DOC
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01/09/98 14:11 FAX 200 7399900 VCI 004/007
EXHIBIT A
S[te Name 1�� 1� VA{.L�y i�DSP/T�(, PCS Site Agreement site L D. r-God— O/
Site Description
Legal Desaipuon or Pimp":
L
Statutory Warranty Deed
(CORPORATE FORM)
THE GRANTOR ARLINGTON HOSPITAL BUILDING COMPANY, a Corporation,
for and in consideration of $ 175,000.00
in hand paid, conveys and warrants to PUBLIC HOSPITAL DISTRICT NO. 3 OF SNOHOMISH
COUNTY, WASHINGTON, a Municipal Corporation,
the following described real estate, situated in the County of Snohomish , State of
Washington: Beginning at the Northeast corner of the SE 1/4 of the NE 1/4 of
Section 11, Township 31 N.R. 5 E. W.M. , thence south 40 rods following the East
line of said Section 11 to the true point of beginning;thence West 6.66 chains
(439.56 feet) running parallel with the North line of said SE 1/4 of the NE 1/4;
thence south 10 chains (660 feet) more or less, to south line of said subdivision;
thence east 6.66 chains to the southeast corner of said subdivision;thence North
10 chains, more or less, to the true point of beginning,EXCEPT tract beginning on
the south line of said subdivision 30a feet west of tklP s9ut-4east corner of said
subdivision; thence North 200 feet; thence West to the'West line of the aforesaid
tract;thence south to the southwest corner of said tract;thence East along the
south line of said subdivision to the point of beginning. ALSO EXCEPT the followir
described tract: Beginning at the Northeast corner of the SE 1/4 of the NE 1/4 of
said section;thence south along the East line of said subdivision 962 feet to the
true point of beginning;thence West parall'-el to the south line of said subdivisior
229 feet;thence south parallel to the east line of said subdivision for 276 feet t
the south line of said subdivision;thence east along the south line of said sub-
division to the southeast corner thereof;thence North along the east line of said
subdivision to the true point of beginning.ALSO EXCEPT COUNTY road and EXCEPT sucl
land as has been deeded to the Town of Arlington for road purposes :
SUBJECT TO Waiver of Damages , File No . 1090950 Snohomish County Auditor 's Office.
valet WITNESS WHEREOF, said corporation has caused this instrument to be executed by its proper officers
ithv}ate seal to be hereunto affixed this 30th da of March lg 66
�RYOR,q `' n S,oAn ARLI- -GTON HOSPITAL DING COMPANY
SEAL NO SALES l Any...................� v• . .... . . .. ... .................
• � • *195�
REQUIRED
President.
•.O'.•••�;�. •.,.•'` 13y ,GGr�t...�K-tee
�+ata 17117/95 Version 1.0 Seattle
R
, 01/09/90 14:11 FAX 20_0 7399900 VCI Q 004/007
EXHIBIT A
S(te Name 6,4&-4kr_ ,CLL {�bSf'/TAL PCs Site Agreement site t_�. 277-C01- o/
Site Description
Legal Description or Property:
�- _i
L I11
Statutory Warranty Deed
(CORPORATE FORM)
THE GRANTOR ARLINGTON HOSPITAL BUILDING COMPANY, a Corporation,
for and in consideration of $ 175,000.00
in hand paid, conveys and warrants to PUBLIC HOSPITAL DISTRICT NO. 3 OF SNOHOMISH
COUNTY, WASHINGTON, a Municipal Corporation,
the following described real estate, situated in the County of Snohomish State of
Washington: Beginning at the Northeast corner of the SE 1/4 of the NE 1/4 of
Section 11, Township 31 N.R. 5 E. W.M. , thence south 40 rods following the East
line of said Section 11 to the true point of beginning;thence West 6.66 chains
(439.56 feet) running parallel with the North line of said SE 1/4 of the NE 1/4;
thence south 10 chains (660 feet) more or less, to south line of said subdivision;
thence east 6.66 chains to the southeast corner of said subdivision;thence North
10 chains, more or less, to the true point of beginning, EXCEPT tract beginning on
th® south line of said subdivision 304 feet west of t48 spud}east corner of said
subdivision; thence North 200 feet; thence West to the West line of the aforesaid
tract;thence south to the southwest corner of said tract;thence East along the
south line of said subdivision to the point of beginning. ALSO EXCEPT the followir
described tract: Beginning at the Northeast corner of the SE 1/4 of the NE 1/4 of
said section;thence south along the East line of said subdivision 962 feet to the
true point of beginning;thence West parallel to the south line of said subdivisior
229 feet;thence south parallel to the east line of said subdivision for 276 feet t
the south line of said subdivision;thence east along the south line of said sub-
division to the southeast corner thereof;thence North along the east line of said
subdivision to the true point of beginning.ALSO EXCEPT COUNTY road and EXCEPT suet
land as has been deeded to the Town of Arlington for road purposes :
SUBJECT TO Waiver of Damages , File No. 1090950, Snohomish County Auditor 's Office.
IN WITNESS WHEREOF, said corporation has caused this instrument to be executed by its proper officers
f�e fate seal to be hereunto affixed this 30th da of March
��;:�RY�R.q .• ,� S,oO ARLI- ,GTON_.HOSPITAL DING COMPANY
SEAL NO SALES i Air ... v . .. ... ...................
..........................
G President.
. •�'i955 REQUIRED
B
/ *Seerarv.
Qetev!?l17/95 Verson 1.0 Seattle
,.: �•.
:.:
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01/09/96 14:11 FAX ?(,O 7399900 VCI Q 004/007
EXHIBIT A
Site Name G,4scqpC V,4bL-ey IVSP,PL PG3 Site Agreement site i.D_ T-60/— o/
Site Description
Legal Description or Property:
---------------- ---------------'
L
Statutory Warranty Deed
(CORPORATE FORM)
THE GRANTOR ARLINGTON HOSPITAL BUILDING COMPANY, a Corporation,
for and in consideration of $ 175.000.00
in hand paid, conveys and warrants to PUBLIC HOSPITAL DISTRICT NO. 3 OF SNOHOMISH
COUNTY, WASHINGTON, a Municipal Corporation,
the following described real estate, situated in the County of Snohomish , State of
Washington: Beginning at the Northeast corner of the SE 1/4 of the NE 1/4 of
Section 11, Township 31 N.R. 5 E. W.M. , thence south 40 rods following the East
line of said Section 11 to the true point of beginning;thence West 6.66 chains
(439.56 feet) running parallel with the North line of said SE 1/4 of the NE 1/4;
thence south 10 chains (660 feet) more or less, to south line of said subdivision;
thence east 6.66 chains to the southeast corner of said subdivision;thence North
10 chains, more or less, to the true point of beginning, EXCEPT tract beginning on
tho south line of said subdi.vislon 304 faet west of the s9ut4aast corner of said
subdivision; thence North 200 feet; thence West to the West line of the aforesaid
tract;thence south to the southwest corner of said tract;thence East along the
south line of said subdivision to the point of beginning. ALSO EXCEPT the followir
described tract: Beginning at the Northeast corner of the SE 1/4 of the NE 1/4 of
said section;thence south along the East line of said subdivision 962 feet to the
true point of beginning;thence West parallel to the south line of said subdivisior
229 feet;thence south parallel to the east line of said subdivision for 276 feet t
the south line of said subdivision;thence east- along the south line of said sub-
division to the southeast corner thereof;thence North along the east line of said
subdivision to the true point of beginning.ALSO EXCEPT COUNTY road and EXCEPT suct
land as has been deeded to the Town of Arlington for road purposes :
SUBJECT TO Waiver of Damages , File No. 1090950, Snohomish County Auditor 's Office,
IN WITNESS WHEREOF, said corporation has caused this instrument to be executed by its proper officers
date seal to be hereunto affixed this 30th A:2=
of March � Ig 66
PaR,q•� ,I S,aOn ARGTON HOSPITAL DING COMPANY
7 .M la, S —
• r SEA N O SALES l A�v..............................................
- • �
• REQUIRED / "� President.
.
g of
•.,a. .••rre. •• . X- Se_=_ rV.
•... ......................
�hai4:lZR7/95 Version 1.0 S*Vft
01/09/96 14:11 FAX 2nq 7399900 VCI 004/007
I // EXHIBIT A
S[te Name G14scr�rx k4b �Z IVOS�0157(- PUS Site Agreement Site[.D. 1(16e7—G0/— o/
Site Description
Legal Descriptlon or Property:
- i
L 1I1
Statutory Warranty Deed
(CORPORATE FORM)
THE GRANTOR ARLINGTON HOSPITAL BUILDING COMPANY, a Corporation,
for and in consideration of $ 175 .000.00
in hand paid, conveys and warrants to PUBLIC HOSPITAL DISTRICT NO. 3 OF SNOHOMISH
COUNTY, WASHINGTON, a Municipal Corporation,
the following described real estate, situated in the County of Snohomish State of
Washington: Beginning at the Northeast corner of the SE 1/4 of the NE 1/4 of
Section 11, Township 31 N.R. 5 E. W.M. , thence south 40 rods following the East
line of said Section 11 to the true point of beginning;thence West 6.66 chains
(439.56 feet) running parallel with the North line of said SE 1/4 of the NE 1/4;
thence south 10 chains (660 feet) more or less, to south line of said subdivision;
thence east 6.66 chains to the southeast corner of said subdivision;thence North
10 chains, more or less, to the true point of beginning,EXCEPT tract beginning on
thn south line of said subdivision 304 fact west of the Fqu-Eheast corner of said
subdivision; thence North 200 feet; thence West to the West line of the aforesaid
tract;thence south to the southwest corner of said tract;thence East along the
south line of said subdivision to the point of beginning. ALSO EXCEPT the followir
described tract: Beginning at the Northeast corner of the SE 1/4 of the NE 1/4 of
said section;thence south along the East line of said subdivision 962 feet to the
true point of beginning;thence West parallel to the south line of said subdivisior
229 feet;thence south parallel to the east line of said subdivision for 276 feet t
the south line of said subdivision;thence east- along the south line of said sub-
division to the southeast corner thereof;thence North along the east line of said
subdivision to the true point of beginning.ALSO EXCEPT COUNTY road and EXCEPT sucl
land as has been deeded to the Town of Arlington for road purposes :
SUBJECT TO Waiver of Damages , File No. 1090950, Snohomish County Auditor 's Office .
IN WITNESS WHEREOF, said corporation has caused this instrument to be executed by its proper officers
date seal to be hereunto affixed this 30th lofMarch 19 66
AR -HOSPITAL DING COMPANY
. : ;S A , NO SALES TA�v----------------- - v�,
i *z95, REQUIRED Presidext.
Stcretasv.
uaia��rci�5 Version 1.0 SeatHe
46
C
rA
ARLINGTOM GENERAL HOSPITAL
INTRODOCTIONI
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SITE
The site is 'I" shaped, being 403.26' on the north and 411.15'
on the West. The South has a 75xl70' extension to Highlands
Ave. , and 302' on the east side fronting Stillaguamish Ave.
The subject property is bounded on the north by residential,
on the east by scattered residence and agriculture, on the
south by residential, and on the west by residential and
unimproved land. The Site is level and planted in grass with
the exception of the west side, which has a downward slope,
and the southerly 75x170' also having a slope; both areas are
overgrown with trees. There is a 107x153' parking area on the
south side of the building, with a 8x96' landscaped island
where the flag pole is located. To the rear is a 60x130'
paved parking area for the employees. Utilities consist of
city water and sewers which are connected.
Area Computation:
302.00x 195.8 59,131
75.00x 411.2 30,840
135.56z 411.2 55,742
75.00z 170.0 12, 750
158,4630'
158,463 / 43,560 - 3.6 acres
RME: The area computation has been made from the dimensions given
on Sheet 1 of Architect's plans dated March 19, 1957.
4
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*PA
ARLINGTOM CLNERAL HOSPITAL
INTRODUCTION
°
SITE
The site is "T'° Shaped, being 403.26'
on the West. on the north and 411.15'
The south has a 75xl7O' extension to Highlands
Ave. , and 302' on the east side fronting Stillaguem .
The subject property is ish Ave
bounded on the north by residential,
on the east by scattered residence and agriculture, on the
south by residential, and on the west by residential and
unimproved land. The site is level and planted in grass with
the exception of the west side, which has a downward slope,
and the southerly 75470' also having a slope; both areas are
overgrown with trees. 'Mere is a 107453' parking area on the
south side of the building, with a 8x96' landscaped island
where the flag pole is located. To the rear is a 60xl30'
Paved parking area for the employees. Utilities consist of
city water and sews
rs which are connected.
Area Computations
302.00x 195.8 59,13
75.00x 411.2
30,84d
135
•56z 411.2 53,74 .•
75.00x 170.0 12 750
158,4630'
158,463 / 43,560 • 3.6 acres
Rom: The area computation has been made
f on Sheet 1 of Architect's Plana dat d Narch 19 dimensions the 1957. given
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City of Arlington Fax:360-435-3906 Apr 3 '96 16:54 P. 02
7sq-0101c1))
CITY OF ARLINGTON
CONSTRUCTION
PERMIT
❑ C01,191NATION WILDING ❑ MECHA141CAL ❑ PLUM13ING ❑ $ION PERMIT NO.
MAILAOURl9S CITY ZI O E N o�I33'
s� 33 S- S L.Lf�G- - i1SN ,t` L�In�r{.'.- L;� ;Z _
11
ARCIIIIFCT 04 DESIGNER MAILADURESS CITY
&Q-5 i10c :,t. -`;i �S6I'q ZC,_;) S'C�C_-j i,vi? )Tj r Zo 6j (�Z3-1860
11110tgAt MAIL AOURE S City t O
C A IC COTO MAIL A UItESS CITY ZIP PHONE LICENS
PLUMVIAG CONTRACTOR MAIL ADORE IS CITY il► MoNt C S
t I
CLASS of WoRk
VNLW ❑AUDITION ❑ALTERATION ClREPAIR ❑UEMULI I ION ❑BUILDING RELOCATIVALUATION Of WORK
1 2.<:./ COO
ulscRHt:WORK
rv-- uA/j 6,�' 0/V8
RuruS oust of lVIL01NC
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA-
k 0 L Y., �_ ;?U'A �X{S iii u J S C TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROYI-
4,A TTV-1il,I lvA of FOROw alk Al Imiu R C SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK
wt RLt7CK or ., WILL BE COMPLIED WITH WI-IETHER SPECIFIED HERIN OR NOT,THE
GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO
VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR
TAX ID NUMBER Fi10M PROPETITY TAX 6TATIEM6Ht LOCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF
I — I— t�aq— cc CONSTRUCTION.PERMIT EXPIRES I YEAR FROM DATE OF ISSUANCE.
11OMATUR10f COW?RACtOR Olt AUT1101uLE0AUNT OATI
O
t 33a S. S�( 1�tri. v►ISj� O� d- x
PLUMOI 4130LANICAL
IA
TrrE OP PIILTUR4 PBO PIEIURas 0. TY A OF GQUIFMBHT F58 s FIXTURES
CLosur IU116 J 17.f0 U%lCORD.UNIm--11l_ RA_
llITUR II?A REQIDLATION U ill-Ill.LTA. d .Ia"•
VATOILT ASIE BARIN 11.0 OLARS-I1.l.BA. d ,ut
ow= TAD A5 FMBD AA.UNRD-TONNIA0B" d I NA "
CIMM 5114E A DISPOSAL 11.00 ORC AID AIR ATF181411-B T.U. MMA 11.90
SIIWABIIBR 17.00 Al L 1113ATBRA-B.T.U. M 0.00
UNDRY TRAT lT.M NET MATE"-B-T U. m
W111011 WASIIBR 11.M VAPORATTVBCOOLZId
18R IIBATER IlIm LD711ES1DRTE11t5ENAL 1T.90 BN UtTEON PAN 130
INTCING POUNTAIN 11 00 OB1100D C0mmnRCIAL 3ESO
OOK DRAIN iA1 TRIIANDUMOUNIT- Cl'MCUUM BRISAR11RS li.00 VB 6.SOOP DRAINS-JWNLE ADBRIt 11.14 BTAL FIKBPLtCIE A CIHNNBT li139NL I111IRVICIS-BAR ETC.) ATUR IISATE[R li31
A5 HPBla .1 eP Ia 3-ITSD,1UsL-M' _
-- "ET&*wgyl Rat mutt be tro.l9d
SUB TOTAL MUD TOTAL
rwtmIT PetHrT _
TOTAL FBI IDTAL FOR
SI ARII SAC tlkt]Ll illiACK R A r IlblEtElAtK PLANCIIECK04UM9lR PLAN CIITCK F
FEE RECEIPT NO,
OU MAI LutVACANT III
❑YES []NO FEES VALUATION FEE
I v?i 01 CONS I. OCCUPANCY GROUP NO.OF DWELLING UNIII PLAN Cl IECKINO VO
1
Wt UI OLIX, NO.Oi S1URII.$ MAR•UCC.LOAD BU'lDINO S
RuMTIINa
t IRE SPRINKLER!RLOUIREIT
❑YES NO MECIIANICAL
COMMENTS TAl'1 BLISO.COOS
ENERGY COOS SUAWAROE u
PENALTY SEC�iv1f�1
WAIERISEWER FEES
rlm_'V Y.
f� TOTAL
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PEWIT VALIDATION
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� D VALLEY H4SPlTAL.
APPLICATION (.e/NSTRUCTION INFORMA ON
FOR: Certificate of Zoning Compliance ❑ To CITY of ARLINGTON CLASS of WORK (check) NEW A_, ALTERATION ❑ ; ADDITION , DEMOLISH ❑.
Building Department / /
Building Permit Describe Alteration_ r/7 c4 li aoNC) : 0 D 12 Td C_-4 Gf
Certificate of Occupancy ❑ Date d' _7 92
NOTICE: No permit for erection, alteration, moving, repair or occupancy of any building
shall be issued until an application has been made and approved for a certifi- Valuation based on total floor area $ 36. Z q l' N O T I C E
cate of zoning compliance. �- Where work is started
Plan checking fee \1 $
before permit is obtained
WN the permit fee shall
Owner of C p67 Address A. 13 5`rj4&ACUAM131% RILL# -rate Permi=,Y�e 4� $s3- O 9 be doubled.
Permittee '5k rr%F Address
Qr ��
� 0
Architect Rot3Er1ZT h1. SI•4OINIAL-TIE_tE_�' Address 315tj AML. Wei SPECIFICATIONS
Engineer Address
FOUNDATION Exterior Piers COVERING _
Contractor T o tB 'a44%Aj Address 1415 22D"sr. IJ.LU s onl,
Material Exterior walls T/r/ S g
-� Width at top Interior walls
LEGAL MCRIPTION OF PROPERTY: Lot No. Block No.
p.
Subdivision or Unplatted description Sim; Ot.�1G, Width at bottom Roof or reroofing /0 At/Qo11R"_,,`Le
Depth in ground
y 2v13 ZONING INFORMATION FRAME Size Spacing Span FLUES
TYPE OF OCCUPANCY of present or TYPE of CONSTRUCTION of present or R.W.Plate(sill) 2 X Fireplace
proposed main building (circle) proposed main building (circle) Girders Floor furnace
A B C D E F G H I J 1 II Ili III 1 hr. III HT Joist, Istfloor SLvb --1 Ad Kitchen
DIVISION 1 2 3 4 IV IV 1 hr. V V 1 hr. Joist,2nd floor 2 $ �6 oh C (rX1577NO)ter heater
Joist,ceiling rrG'SS� ST a l's Furnace
Use Zone Fire Zone _ Area of Lot
Size of building or addition No.of stories Exterior studs .-A 4f I6 pp C Gas Oil
Total height Basement floor area 1 st Floor area
Interior studs
Additional floors and areas
No.of rooms No.of families Roof rafters t /2 orlLo �l 2
No.of buildings now on lot Use of buildings now on lot
Bearing walls 2 �( �- �E7"&7 C
Percentage of lot covered by main building Additional Permits are required for: a
Percentage of lot covered by accessory buildings (check) IMPORTANT
Kind of livestock
❑ Plumbing, ❑ Signs, ❑ Moving, Written authorization of owner must
CHANGE OF OCCUPANCY from to ❑ Sewer hookup, ❑ Water hookup, be presented when applicant is occupant
If a commercial building,list each use and its area in square feet: ❑ Gas opplionce and Gas piping. or lessor. I am the legal owner of the
I hereby acknowledge that I have read this application and property described in this application.f
state that the above is correct and agree to comply with all
city ordinances and State Laws regulating zoning and buildiri i
DRAW on the reverse side of this application, to scale, a PLOT PLAN. APPLICANT %�
i
PLOT PLAN FOR DEPARTMENI HL USE
FOR DEPARTMENTAL USE l Application for Certificate of Zoning Compliance
❑
Draw below,to scale, a plot plan showing: J pp g p
Checked Initials
1. Dimension and shape of the lot. 1.
2. Front street name. 2, Building Permit Certificate of Occupancy ❑ checked and approved.
3. Side street name if corner lot. 3. /
4. Sizes and location on the lot of buildings already existing. 4. /r
5. Location and dimensions of proposed building or alterations. 5. Building Inspector Date
6. Front yard,side yard,rear yard setbacks. 6. O �P
7. Locate and describe any fences,walls,hedges,signs, 7. Issued Building Permit No. Date
front yard trees and shrubs,green belt.
8• localion and size of required off-street parking and loading. 8.
v1 p a- INSPECTION RECORD
0
3 o q of Inspection Date Signature
Set Back
Excavation
Concrete
Reinforced Steel
66 Grout Blocks
Bond Beam
Frame
Roofing
Room Ventilation
Y Kitchen Vent
Bathroom Vent
Foundation Vent
Access Hole
Garage Fireproofing
Fireplace
Spark Arrester
Water Closet
Water Heater
Sewage Disposal
Lathing
Plastering
Correction Order Left
Stop Work Order Issued
Stop Work Order Released
c Give brie Port of special or unusual cond' ions
Job completed Date
Building Inspector
Certificate of Zoning Compliance No. Issued
Date
Certificate of Occupancy No. Issued
Date
MOORE BUSINESS FORMS INC..LA
APPLICATION CC..JSTRUCTION INFORMATION
FOR: Certificate of Zoning Compliance ❑ To CITY of ARLINGTON CLASS of WORK (check) NEW�<ALTERATION El DEMOLISH, 11 .
❑ , ADDITION
Building Department Building Permit a Describe Alteration
Certificate of Occupancy ❑ Date_ 797 - /
NOTICE: No permit for erection, alteration, moving, repair or occupancy of any building � n
shall be issued until an application has been made and approved for a certifi- Valuation based on total 4or oreai �,'� $ /,57 0 N O T I C E
cote of zoning compliance. Where work is started
Plan checking fee f $
i _-_� �JU before permit is obtained
the permit fee shall
Owner t
Address 33 �� ��t- Gcc Permit to be doubled.
Permittee_ _ Address -
Architect - Address
SPECIFICATIONS
Engineer Address
__� Q FOUNDATION Exterior Piers COVERING
Contractor-L� G"� �""� 4 a Address 2 YJ Wy Material Exterior walls
LEGAL DESCRIPTION OF PROPERTY: Lot No. Block No. Width at top Interior walls
Subdivision or Unplatted description Width at bottom Roof or reroofing_
Depth in ground
ZONING INFORMATION FRAME Size Spacing Span FLUES
TYPE OF OCCUPANCY of present or TYPE of CONSTRUCTION of present or R.W.Plate(sill) Fireplace
proposed main building (circle) proposed main building (circle) Girders Floor furnace
A B C D E F G H I J III III III 1 hr. III HT Joist, 1st floor Kitchen
DIVISION 1 2 3 4 IV IV 1 hr. V V i hr. Joist,2nd floor Water heater
Joist,ceiling Furnace
Use Zone _ Fire Zone - _Area of Lot
Size of building or addition No.of stories Exterior studs Gas Oil
Total height Basement floor area I sl Floor area
Interior studs
Additional floors and areas
No. of rooms _No.of families__ Roof rafters
No.of buildings now on lot Use of buildings now on lot
Bearing walls
Percentage of lot covered by main building. Additional Permits are required for:
Percentage of lot covered by accessory buildings (check) IMPORTANT
Kind of livestock - ❑ Plumbing, ❑ Signs, ❑ Moving,
Written authorization of owner must
CHANGE OF OCCUPANCY from to ❑ Sewer hookup, ❑ Water hookup, be presented when applicant is occupant
If a commercial building,list each use and its area in square feet: ❑ Gas appliance and G s piping. or lessor. I am the legal owner of the
Nam, property described in this application.
I hereby acknowledge that I hav read this application and
state that the above is correct and agree to comply with all
city ordinpnce nd tote s re Igtltg z i ar>�building
Owner
DRAW on the reverse side of this application,to scale, a PLOT PLAN. APPLICAN
PLOT PLAN FOR DEPARTMENTAL jSE
Draw below,to scale, a plot plan showing: FOR DEPARTMENTAL USE Application for Certificate of Zoning Compliance ❑
Checked Initials
1. Dimension and shape of the lot. 1.
'2. Front street name. 2. Building Permit X1_ Certificate of Occupancy ❑ checked and approved.
3. Side street name if corner lot. 3.
4. Sizes and location on the lot of buildings already existing. 4.
5. Location and dimensions of proposed building or alterations. 5. Building Inspector Date
6. Front yard,side yard,rear yard setbacks. 6. p
2-?7. Locate and describe any fences,walls, hedges,signs, 7. Issued Building Permit No_ ��/ Date
front yard trees and shrubs,green belt.
8. Location and size of required off-street parking and loading. 8.
INSPECTION RECORD
Inspection Date Signature
Set Back
Excavation
Concrete /
Reinforced Steel
Grout Blocks
Bond Beam
Frame
Roofing
Room Ventilation
^� Kitchen Vent
Bathroom Vent
Foundation Vent
Access Hole
Garage Fireproo /,)
/V
Fireplace
Spark Arre/�er
Water Clos
Water He
Sewage isposal
Lathin
Plastering
Correction Order Left
Stop Work Order Issued
Stop Work Order Released
V*iverief report of special or unusual conditions
���Q
Job completed '� Ddte �/
�.LL-L
Building Inspector-
Certificate of Zoning Compliance No. Issued
Date
Certificate of Occupancy No. Issued
Date
MOORE BUSINESS FORMS INC LA
APPLICATIGA CONSTRV.,rION INFORMATION
FOR: Certificate of Zoning Compliance ❑ To CITY of ARLIN ON CLAS f WORK (check) NEW ALTERATION ❑ , ADDITION ❑ , DEMOLISH ❑ .
Building Department . . i
Building Permit ❑ Describe Alteration
Certificate of Occupancy ❑ Date__'/`/�
NOTICE: No permit for erection, alteration, moving, repair or occupancy of any building
shall be issued until an application has been made and approved for a certifi "'Y'" �G�
PP Pp Valuation based on total floor area � $ ,�C:� ' N O T I C E
cate of zoning compliance. n Where work is started
Plan checking fee �.� $
'�
19 before permit is obtained
1 n
Owner_ L0 Address ` �c' � Permit fee
I� JJ °`s,'' rJ � the permit fee shall
i $ be doubled.
Permittee_ Address
Architect_ Address
SPECIFICATIONS
Engineer Address
FOUNDATION Exterior Piers COVERING
Contractor_ Address
Material Exterior walls
LEGAL DESCRIPTION OF PROPERTY: Lot No. Block No. Width at top Interior walls
Subdivision or Unplatted description Width at bottom Roof or reroofing
Depth in ground
ZONING INFORMATION FRAME Size Spacing Span FLUES
TYPE OF OCCUPANCY of present or TYPE of CONSTRUCTION of present or R.W.Plate(sill) Fireplace
proposed main building (circle) proposed main building (circle) Girders Floor furnace
A B C D E F G H I J I II III III 1 hr. III HT Joist, Istfloor Kitchen
DIVISION 1 2 3 4 IV IV 1 hr. V V 1 hr. Joist,2nd floor Water heater
Joist,ceiling Furnace
Use Zone Fire Zone Area of Lot
Size of building or addition No.of stories Exterior studs Gas Oil
Total height Basement floor area 1st Floor area _
Interior studs
Additional floors and areas
No.of rooms No.of families Roof rafters
No.of buildings now on lot Use of buildings now on lot
Bearing walls
Percentage of lot covered by main building Additional Permits are required for:
Percentage of lot covered by accessory buildings - —. (check) IMPORTANT
Kind of livestock
❑ Plumbing, ❑ Signs, ❑ Moving, Written authorization of owner must
CHANGE OF OCCUPANCY from to ❑ Sewer hookup, ❑ Water hookup, be presented when applicant is occupant
If a commercial building,list each use and its area in square feet: ❑ Gas appliance and Gas piping. or lessor. I am the legal owner of the
I hereby acknowledge that I have read this application and property described in this application.
state that the above is correct and agree to comply with all
city ordinances and State Laws regulating zoning and building
Owner
DRAW on the reverse side of this application, to scale, a PLOT PLAN. APPLICANT
PLOT P6.,A FOR DEPARTMENTAL USE
ENTAI USE
Draw below,t0 Scale,p plot plan showing: FOR DEPART Application for Certificate of Zoning Compliance ❑
Checked Initials
1. Dimension and shape of the lot. 1.
2. Front street name. 2. Building Permit Certificate of Occupancy ❑ checked and approved.
3. Side street'name if corner lot. 3.
4. Sizes and location on the lot of buildings already existing. 4.
5. Location and dimensions of proposed building or alterations. 5. Building Inspector l Date6r?Z�
6. Front yard,side yard, rear yard setbacks. 6. �- s
7. Locate and describe an fences,walls,hedges,signs, 7. 1
Y g 9 Issued Building Permit No. � � [ Date
front yard trees and shrubs,green belt.
8. Location and size of required off-street parking and loading. 8.
INSPECTION RECORD
Inspection Date Signature
Set Back
Excavation
Concrete
Reinforced Steel
Grout Blocks
Bond Beam
Frame
Roofing
Room Ventilation
Kitchen Vent
Bathroom Vent
Foundation Vent
Access Hole
Garage Fireproofing
Fireplace
Spark Arrester
Water Closet
Water Heater
Sewage Disposal
Lathing
Plastering
Correction Order Left
Stop Work Order Issued
Stop Work Order Released
Give brief report of special or unusual conditions
Job completed Date
Building Inspector
Certificate of Zoning Compliance No. Issued
Date
Certificate of Occupancy No. Issued
Date
MOORE BUSINESS FORMS INC.LA
APPLICATION CONSTRUCTION INFORMATION
FOR: Certificate of Zoning Compliance ❑ To CITY of ARLINGTON CLASS of WORK (check) NEItV-�ALTERATION ❑ , ADDITION ❑ , DEMOLISH ❑.
Building Department y� �,/ _ j
Building Permit / Describe Alteration �d T- �e - e lei- 4 a__
Certificate of Occupancy /❑ Date (0 r ��v _
NOTICE: No permit for erection, alteration, moving, repair or occupancy of any building �0 oa
shall be issued until an application has been made and approved for a certifi- Valuation based on total floor area $ N O T I C E
cate of zoning compliance. Where work is started
Plan checking fee $ before permit is obtained
3 s 'r1� ' �
Owner 2- Address_ e� . i i q�Lc-.ysct (JT� the permit fee shall
PtFmit fee ���� $ be doubled.
r r ,
Permittee Address
Architect Address V SPECIFICATIONS
Engineer_ Address �1
FOUNDATION Exterior Piers COVERING
yContrr ,-dQr, AVA �� G,�(�•t-S w� �''� Address
Material Exterior walls
Width at top Interior walls
'EGAL DESCRIPTION OF PROPERTY: Lot No. Block No.
Subdivision or Unplatted description Width at bottom Roof or reroofing_
Depth in ground
INFORMATION FRAME Size Spacing Span FLUES
TYPE OF OCCUPANCY of present or TYPE of CONSTRUCTION of present or R.W.Plate(sill) Fireplace
proposed main building (circle) proposed main building (circle) Girders Floor furnace
A B C D E F G H I J 1 II III III 1 hr. III HT Joist, 1st floor Kitchen
DIVISION 1 2 3 4 IV IV 1 hr. V V 1 hr. Joist,2nd floor Water heater
Joist,ceiling Furnace
Use Zone Fire Zone Area of Lot
Size of building or addition__ No.of stories Exterior studs Gas Oil
Total height Basement floor area __ _1st Floor area.
Interior studs
Additional floors and areas
No.of rooms No.of families Roof rafters
No.of buildings now on lot Use of buildings now on lot _ _
Bearing walls
Percentage of lot covered by main building Additional ermits are required for:
Percentage of lot covered by accessory buildings (check) IMPORTANT
Kind of livestock
tubing, ❑ Signs, ❑ Moving, Written authorization of owner must
CHANGE OF OCCUPANCY from to ❑ Sewer hookup, ❑ Water hookup, be presented when applicant is occupant
If a commercial building,list each use and its area in square feet: ❑ Gas appliance and Gas piping, or lessor. I am the legal owner of the
property described in this application.
I hereby acknowledge that I have read this application and
state that the above i correct and agree to comply wit"I
city ordinances a Laws r lat' g zoning and b r, ng
Owner
DR, on the reverse side of this application,a -ale, a PLOT PLAN. APPLI
PLOT PLAN FOR DEPARTMENTAL USE
Draw below,to scale, a plot plan showing: FOR DEPARTMENTAL USE Application for Certificate of Zoning Compliance ❑
Checked Initials
1. Dimension and shape of the lot. l.
2. Front street name. 2. Building Permit, Certificate of Occupancy ❑ checked and approved.
3. Side street name if corner lot. 3.
4. Sizes and location on the lot of buildings already existing. 4. O
5. Location and dimensions of proposed building or alterations. 5. Building Inspector. t' _ Dote r3 r�
b. Front yard,side yard, rear yard setbacks. 6. ��� /`U
7. Locate and describe any fences,walls, hedges,signs, 7. Issued Building Permit No. Date
front yard trees and shrubs,green belt.
8. Location and size of required off-street parking and loading. 8.
INSPECTION RECORD
Inspection Date Signature
Set Back
Excavation
II Concrete
Reinforced Steel
Grout Blocks
Bond Beam
. Frame
. Roofing
Room Ventilation
Kitchen Vent
Bathroom Vent
Foundation Vent
Access Hole
Garage Fireproofing
Fireplace
Spark Arrester
Water Closet
Water Heater
Sewage Disposal
Lathing
Plastering
Correction Order Left
Stop Work Order Issued
Stop Work Order Released
Give brief report of special or unusual conditions
.!
Z&OJob completed / Dote• -5 5v
Building In actor
Certificate of Zoning Compliance No. Issued
Date
Certificate of Occupancy No. Issued
Date
MOORE BUSINESS FOiJMS INC LA