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Home My WebLink About21015 STATE ROUTE 9 NE_BLD1399_2026 `\A(,,u,�`V L� TO PERMITEE AND/OR OWNER ❑; PARTIAL APPROVAL ❑ CORRECTIONS REQUIRED ❑ DO NOT OCCUPY 0 APPROVED PERMIT#: fj C LOT#: DATE: JOB ADDRESS: TYPE OF INSPECTION: ❑ NO PERMIT-STOP WORK-OBTAIN PE MIT:AND MAKE WORK COMPLY WITH CURRENT BUILDING AND/OR PLANNING CODES. ❑ CONSTRUCTION IS NOT IN ACCORDANCE WITH APPROVED PLANS AND PERMIT -STOP WORK: MAKE EXISTING WORK COMPLY WITH APPROVED PLAN AND PERMIT OR REMOVE IT. ❑ STOP WORK UNTIL AUTHORIZED TO CONTINUE BY INSPECTOR. ❑ CORRECTIONS LISTED BELOW MUST BE MADE BEFORE WORK CAN BE APPROVED. ❑ WORK NOT READY FOR INSPECTION:$50 REINSPECTION FEE(PER IBC) MUST BE PAID PRIOR TO NEXT INSPECTION. ❑ CONTACT INSPECTOR 360-403-3551 ❑ CALL FOR REINSPECTION -Igoe - " � , ,ir 7,. K=c THE ACTIONS OR CORRECTIONS INDICATED ABOVE ARE REQUIRED WITHIN DAYS OR PENALTIES IMPOSED BY LAW MAYAPPLY. FOR INSPECTION CALL: 360-403-3417 -311 ZXL-F INSPECTOR DA'i L F UILDING DEPT. O PLANNING DEPT. CITY OF ARLINGTON J J F > CITY Off' ARLINGTON i 238 N. OLYMPIC AVE-ARLINGTON,WA. 98223 PHONE; (360)403-3551 PJf 4'4ii ti .: wnr tEF 2``" a:a 9 rn } Address:21015 SR 9 Permit#r 1399 Parcel#:31051100400500 Valuation: 15000.00 MM 819a n 4�1 _ Nance:COOK INVESTMENTS NW Name:Amerigas Propane Name:AmeriGas Address: 18818 TELLER AVE STE 277 Address:4509 I52nd Street NE Address:4509 152nd Street NE City,State Zip:IRVINE,CA 92612 City,State Zip:Marysville,WA 98271 City,State Zip:Marysville,WA98223 Phone: Phone:360-591-4117 Phone:360-59t-4117 yj[��, f .5.TO .. . ._ J Name: Name: - Address: Address: City,State,Zip: City,State,Zip: Phone: Phone: LIC#: F..XP: LIC#: EXP: _..: �a:� ;a�::. 4.:a:::. e:... ::r::::n:- G: t? :DE + RIPT + �T.t 6 Y tir... .. ..a. .oi'._ F p Ct�1,,.a:. �:•.-.,., ....,..,,. ........:.... ...[t.....n it.�M.,F':::..r 3 r«.�%i..:...tYi...;1.Mir, .. PERMIT TYPE: Commercial Mechanical CODE YEAR: 2015 STORIES: 1 CONST.TYPE: DWELLING UNITS: 0 OCC GROUP: BUILDINyyGS: 0 OCC LOAD: i PERMIT Alp'PR 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. i 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/IRCI I0. J , SALES TAX NOTTICE:Sales tax relating to construction and construction materials in Choi f Ate, 'otgtl must he reported on your sales tax return form and cod d City of Arlington#3101. O�v a Signature Print Name Date Released By Date _ 3 rah'>.•,....3• .4,.I.5.^.::.'::ir'r.`: I tt c,.-:3 • i .,� t:si�r 3-r +�..r.6 .< Y L nrY .dyWl' -----. . Seeredlined p1anS for addfional requirements:Adhere to approved plans. TK[S PERMIT AUTHORIZS ONLY TI4E WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVPWAYS,MARQUEES;ETC.)WILL REQUIRE SEPARATE PERMISSION. ]�E�T 1�Ex7 I Date Description Fee Amount 4/2412017 Building Permit Fee $354,68 1 4/24/2017 Building Ilan Review Fee $230.54 4124/2017 ProcessingfTechnology Fee $25.00 4f24/2017 State Building Code Surcharge Fee $4,50 Total Due: $614.72 Total Payment, $230.54 �r i1�7y F� Balance Due: S384.18 t BUU.DING(360)403-3411 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 ��Qzd Cz N ` z �. rn Ll h 3 da N x (L {'`+( OlyfnplE Place 200`to Hwy 9 •• -•.- .. - wj Y .Ark y CITY OF ARLINGTON 238 N. OLYMPIC AVE-ARLINGTON, WA. 98223 PHONE; (360) 403-3551 BUILDING PERMIT Address:21015 SR 9 Permit#: 1399 Parcel#:31051100400500 Valuation: 15000.00 OWNER APPLICANT CONTRACTOR Name:COOK INVESTMENTS NW Name:Amerigas Propane Name:AmeriGas Address: 18818 TELLER AVE STE 277 Address:4509 152nd Street NE Address:4509 152nd Street NE City,State Zip:IRVINE,CA 92612 City,State Zip:Marysville,WA 98271 City,State Zip:Marysville,WA 98223 Phone: Phone:360-591-4117 Phone:360-591-4117 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City,State,Zip: City,State,Zip: Phone: Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Commercial Mechanical CODE YEAR: 2015 STORIES: I 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. IBC110/IRC110. SALES TAX NOTICE: Sales tax relating to construction and construction materials in the Ci"t f-"i ton must be reported on your sales tax return form and coded City of Arlington#3101. t tXc- `1Z / Signature Print Name Date Released By Date CONDITIONS See redlined plans for additional requirements. Adhere to approved plans. THIS PERMIT AUTHORIZE 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 4/24/2017 Building Permit Fee $354.68 4/24/2017 Building Plan Review Fee $230.54 4/24/2017 Processing/Technology Fee $25.00 4/24/2017 State Building Code Surcharge Fee $4.50 Total Due: $614.72 Total Payment: $230.54 Balance Due: $384.18 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 zp c PAligogabbs A = 1 > 6 O con> �' -0 Z ` '0 G) �In - - - t.-4 TWA rn =n � Z � m =7 -a O n� oTi N 0 ID a \. 71 T I w � C . 125' --;= `<— -- -----200'to Hwy 9 - VVV Olympic Place J 'O O �r— — v'. Q � CM E _ -- � - ET e V NOTICE TO PERMITEE AND/OR OWNER Cl, PARTIAL APPROVAL ❑ CORRECTIONS REQUIRED ` ❑ DO NOT OCCUPY /Zl APPROVED i PERMIT#: I f Li LOT#: DATE: ' JOB ADDRESS: 2, y C I Cam- V_ l TYPE OF INSPECTION: ❑ NO PERMIT-STOP WORK-OBTAIN PERMIT:AND MAKE WORK COMPLY WITH CURRENT BUILDING AND/OR PLANNING CODES. ❑ CONSTRUCTION IS NOT IN ACCORDANCE WITH APPROVED PLANS AND PERMIT -STOP WORK: MAKE EXISTING WORK COMPLY WITH APPROVED PLAN AND PERMIT OR REMOVE IT. ❑ STOP WORK UNTIL AUTHORIZED TO CONTINUE BY INSPECTOR. Cl CORRECTIONS LISTED BELOW MUST BE MADE BEFORE WORK CAN BE APPROVED. ❑ WORK NOT READY FOR INSPECTION:$50 REINSPECTION FEE(PER IBC) MUST BE PAID PRIOR TO NEXT INSPECTION. ❑ CONTACT INSPECTOR 360-403-3551 ❑ CALL FOR REINSPECTION (�O r'. THEACTIONS OR CORRECTIONS INDICATED ABOVE ARE REQUIRED WITHIN DAYS OR PENALTIES IMPOSED BYLAW MAYAPPLY. FOR INSPECTION CALL: 360-403-3417 INSPECTOR DATIf AUILDING DEPT. O PLANNING DEPT. CITY OF ARLINGTON r 0 I _ CITY OF ARLINGTON 238 N. OLYMPIC AVE-ARLINGTON,WA. 98223 PHONE; (360)403-3551 Address.21015 SIR 9 Permit#s 1399 Parcel#:31011100400500 Valuation: 15000.00 ,W1TE1 APPLXCANT CONTRACTOR Name:COOK INVESTMENTS NW Name:Amerigas Propane Name:AtneriGas Address:18818 TELLER AVE STE 277 Address:4509 152nd Street NE Address:4509 152nd Street NE City,State ZipARVINE,CA 92612 City,State Zip:Marysville,WA 98271 City,State Zip:Marysvillc,WA98223 Phone: Phone:360-591-4117 Phone:360-591.4117 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR ' Name: Name: Address: Address: City,State,Zip: City,State,Zip: Phone: Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTIONS PERMIT TYPE: Commercial Mechanical CODE YEAR: 2015 STORIES: 1 CONST.TYPE: DWELLING UNITS: 0 OCC GROUP: BUILDINGS: 0 OCC LOAD: 1 PERMIT APPROVAL., r n I AGREE.TO CON1111,Y WITH CITY AND STALL:LAWS REGULACING C'ONSTRUc-nbN 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. i 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. IBCII011RCl 10. NOTICE:SALES TAX Sales tax relating to construction and construction mateMam t c Ci f-r�ei ion rnnst he reported on your sales tax return form and cod�d City of Arlington# 101. D r Signature Print Name j Date Released By Date See redlined plans for additional requirements.� Adhere to approved ,. � oved plans. I THIS PERMIT AUTHORIZS ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY ANY i CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS.SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL,REQUIRE SEPARATE PERMISSION. a PERMIT FEES.. . i i Date Description Fes Amount 4/24/2017 Building Permit Fee $354,68 4/24/2017 Building Plan Review Fee $230,54 I 4/24/2017 ProcessinglTechnDlogy Fee $25 00 4/24/2017 State Building Code Surcharge Fee $4,50 Total Due: $614.72 Total Payment; $230.54 Balance Due: $384.18 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 151:20 p to Hwy 9 Olympic Place AX 57, A It zi IN, L4�- CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 �- - PHONE; (360)403-3551 BUILDING PERMIT Address:21015 SR 9 Permit#: 1399 Parcel#:31051100400500 Valuation: 15000.00 OWNER APPLICANT CONTRACTOR Name:COOK INVESTMENTS NW Name:Amerigas Propane Name:AmeriGas Address: 18818 TELLER AVE STE 277 Address:4509 152nd Street NE Address:4509 152nd Street NE City,State Zip:IRVINE,CA 92612 City,State Zip:Marysville,WA 98271 City,State Zip:Marysville,WA 98223 Phone: Phone:360-591-4117 Phone:360-591-4117 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City,State,Zip: City,State,Zip: Phone: Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Commercial Mechanical CODE YEAR: 2015 STORIES: I 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. IBC110/IRC110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the Cit,ef-rli ton must be reported on your sales tax return form and coded City of Arlington#3101. Signature Print Name Date Released By Date CONDITIONS See redlined plans for additional requirements. Adhere to approved plans. 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 4/24/2017 Building Permit Fee $354.68 4/24/2017 Building Plan Review Fee $230.54 4/24/2017 Processing/Technology Fee $25.00 4/24/2017 State Building Code Surcharge Fee $4.50 Total Due: $614.72 Total Payment: $230.54 Balance Due: $384.18 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 r.• ti .. i I l < 'A.go� ins C:) j 1 V6 3— Vi P 6AMHOI,C)OZ— @:)I?ld:)! WAJO SZT- C, > �z 'l 0 C Lo LU w > 00 CT4 a z NReceived :d 5 MAR 2 8 2017 aw �4 ♦4 Q o �u Co 1 I a �n r r d° 11 II aleIld:'idwbl0 6 FMH o],ODZ -- .SZt- Y � 7 v o � oW Z N F- o E} Z � w °oLl a a -- woW. w a. ZQ 0 0 a' 2 W Received � Q � 2 Z MAR 2 � 20� 17 U a i C_ Lu L d u 1 InformationPermit Date 3/28/2017 Permit Number 1399 Project Name Chinook Lumber Applicant Name Amerigas Propane Applicant Address 4509 152nd Street NE City, State, Zip Marysville,WA 98271 Contact MaryAnn Harding Phone 360-591-4117 Email maryann.harding@amerigas.com Permit Type Commercial Mechanical Site Address 21015 SR 9 Valuation 15000.00 Status Applied Permit Issued Permit Expires Square Feet 0 Type of Construction/Occupancy Load Number of Stories 0 Proposed Use Install 1000 gal LP dispenser Assigned To Launa Peterson Property • •n Owner Information Parcel/:31051100400500 COOK INVESTMENTS NW COOK INVESTMENTS NW 18818 TELLER AVE STE 277 21015 STATE ROUTE 9 NE IRVINE.CA92612 Contractors Contractor .ntact Phone Email Contractor meriGas ar Ann Hardin 60-591-4117 haryann.harding—L3—amerigas.com JAPPLICANT DescriptionFees Fee . - Amount Buildlino Plan Review Feel 345.83.00.001 F230,541 Notes Date . te 3/28/2017 Cannot be issued until SEPA is complete-Ip Uploaded Files Upload File Date— File Uploaded By 3/28/2017 8:57:17 AM crIINOQK LUNIE3ER SEPA 03282017 pot Peterson,Launa I )( 3/28/2017 8:53:18 AM jgjTv OF ARLI, JN PERMIT CHINOOK LUNIBER 03 28 201 Tpc lPeterson,Launa �•VY COMMERCIAL MECHANICAL • PERMIT APPLICATION TN �� 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: 1� New Installation _� Replacement Alteration Project Address: �/.0 J'r'i'1 V' �l yL� / Parcel#: Project Degcriptior fn /A Yh*� E y �' L/ � ��t y�r�Valuation: lJ, Owne OIL L l�L lYL2, Phone#: Address: ��z- c v,--- City: State: Zip: Email Address: I O)D�?_ ikrJootc_" 6 ,d ft-)- — r 1 a i iJaa�_L-� ft, •C--- Contact Person: AllAmtl ,�l�N / Phone Address:r 02 N State. N'Zip: '2 Email Address:!�9/h2�(i}A1�✓• C7Nri),JG�.I�st �r-r_C�1 Contractor Nam ��. / I/h��'-- Phone#: Jvo- Contractor Address: /�� fj'�-t FL- Cit/> l/��%� Stat ip: d fi Email:A1i1X-'Y,W,'J• A11%JG /al��t��i'Gil/. Contact Person.- Al Y/)1'<'— � Contractor License Nurr � 'f '�J/� 6�I �Lk. LL' Expirat&g ' C 6 I 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 AC(evaporator) PACKAGED UNIT UST AC(VRF) DRYER / OTHER �1 . n4.SYJ�/,x �t(� I hereby certi that the, boyy,f6rmation is cor{ t and that the construction on, and the occupancy and the r�sye-o�f'�the above- J described prop\rty will tYe hl c4anc�wiitth�tthe Irws, les a �i regulation of the State of Washing ton.// VApplicants Signat r v "' Date Applicants Printed Name: � l] FOR STAFF USE ONLY �Received Permit# Accl By Amount Received Receipt# Date r oNt r 7 6/16LP Page 1 of 1 i ,�. OPERATING GU AW 1W PERMIT APPLICATION Department of Community&Economic Development City of Arlington• 18204 59th Ave NE•Arlington,WA 98223•Phone(360)403-3551 Part I Applicant/Building Information 1, I Applicant's Name: CG1r N 0 l/Lt m 615,e Applicant's Address:—ly Is— ,/r 4z- Contact Person• �j",,.l6t-- Telephone: ✓'6 y 5 /• Y//q Address of Premises for which Operating Permit is requested: Same as above ❑ Other(specify): Tax Parcel ID#: 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. Please indicate the type(s)of Operating Permit(s) requested by checking each applicable box. (If you require assistance,or would like more information, contact the City of Arlington Building Department at 360-403- 3551.) Manufacturing,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 wil I be manufactured,stored or handled(attach additional sheets if necessary): Revised 4/1/08 Page 1 of 4 III I I I I �1 Part II(cont'd) ❑ Conducting 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 process(es)or activity(ies)to be conducted(attach additional sheets if necessary): ❑ Use of pyrotechnic devices in assembly occupancies(see Appendix C.)Describe the devices to be used and type of event(attach additional sheets if necessary): ❑Aboveground Storage Tank(AST) (see Appendix D) ❑ Removal ❑ Decommissioning ❑ Temporary lank closure ❑ Changes in service ❑ Permanent tank closure Brief description: ❑ 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 description of structure and use: Cc: Fire Department Page 2 of i I I i Part II(coat'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 the 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?❑Yes❑No Type: ❑Permanent❑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 I herby certify that the foregoing information(and all information in attached sheets, if any) is true and complete. L/Wo P Signature dT Applicant or Authorized presentatives Signature Date Name and Title(if applicable)of person signing Application(Please print) Cc: Fire Department Page 3 of 4 i Part IV To be co pleted by the City of Arlington Building Department Inspection Required: Yes ❑No Inspections Performed: ❑ Yes ❑No Date of Inspection: 1NILZ 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 Permit): Additional Comments:(Attach additional pages if needed) Cc:Fire Department Page 4 of 4 I OPERATING PERMIT APPLICATION Appendix A Hazardous Materials Storage Department of Community&Economic Development City of Arlington•18204 59th Ave NE•Arlington,WA 98223•Phone(360)403-3551 • An Operating Permit is required when a hazardous material listed in any of the categories in tables 5003.1.1 (1), 5003.1.1 (2), 5003.1.1 (3),or 5003.1.1 (4) of the Fire Code is manufactured,stored,or handled;and the quantity of such hazardous material exceeds the quantity listed in the applicable table. o This includes any building that is,whole or in part,a"Group H"occupancy; is a pre-existing and non-conforming hazardous occupancy; or has outdoor use of,manufactures, and/or stores materials that exceed the tables for physical and/or health hazard. • An Operating Permit will not be issued until an inspection has been performed and establishes,to the satisfaction of the Fire Marshal,that the requirements of the Fire Code are satisfied;including provisions and requirements regarding manufacture, use,and storage,listed in Chapter 50 of the Fire Code. o A previous fire safety inspection will not wave this requirement. • Tests necessary to verify compliance with the Fire Code must be performed by the applicant,and the reports of such tests must be provided to the Fire Marshal. These tests and reports vary from product to product;however,they must include the following requirements: ❑Verification of inspection of the fire protection systems Verification of inspection of storage cylinders,tanks,or containers Presentation of Material Safety Data Sheets(MSDS) Verification of compliance with any other applicable State Agency Revised 9/2016 ti �� !I '--} {: Cal I ke fT [AR r r 'LJ a Lj F- T7 uzj -4 � � 0 MARIGN.sTll I v cr o a I77, �--�- I I I .uj ( City. ofj 1 --� JE NS EAi FA 11 I I , ! r ` 204TH - - -ST777 w i SEPA THRESHOLD DETERMINATION Mitigated Determination of Non-Significance (MDNS) File Name:Chinook Lumber File Number:PLN#333 LeadAgency:City of Arlington,Community and Economic Development Department Description:The Applicant is proposing to install a 1,000 gallon propane LP dispenser for retail use at the existing Chinook Lumber site.The 1,000 gallon tank will be placed on existing asphalt within the parking area and will be located approximately 200 feet from State Route 9, 125 feet from Olympic Place,and 120 from the existing shed. Limon;21015 State Route 9 NE,Arlington,WA 98223 Parcel:310 511-004-00 5-00 Applicant:Chinook Lumber Staff Contact:Amy Rusko,Associate Planner,arusko arlinit )nw,,gpv Date Checklist Preared: March 22,2017 Approvals Required:SEPA Review,Operating Permit,and Mechanical Permit SEPA Threshold Determination:The City has determined that with the mitigation measures identified herein,this proposal would not have a probable significant adverse impact on the environment.An environmental impact statement(EIS) is not required under RCW 43.21C.030 (2) (c).This decision was made after review of a completed environmental checklist and other information on file with the lead agency.This information is available to the public on request. However,we have identified impacts by the proposed project that requires mitigation.In addition to the requirement that the development must comply with all City of Arlington zoning and development regulations,the following conditions of approval of the permit decision apply: (B)(7)(a)(2)Environmental Health In order to mitigate for potential impacts to environmental health the Applicant will need to adhere to the International Fire Code,AMC Chapter 15.24 Storage of Flammable and Combustible Liquids and AMC Chapter 16.32 International Mechanical Code. Disclaimer: The determination that an environmental impact statement does not have to be filed does not mean there will be no adverse environmental impacts.The City of Arlington codes governing noise control,land use performance standards,construction and improvements of roads,off site road improvement obligations,drainage control,traffic,school, park,stormwater,and utility mitigations,fire protection;and building practices will provide substantial mitigation of the aforementioned impacts. The issuance of this MDNS should not be interpreted as acceptance or approval of this proposal as presented.The City of Arlington reserves the right to deny or approve said proposal subject to conditions if it is determined to be in the best interest of the city and/or necessary for the general health,safety,and welfare of the public to do so. Date of Determination of MDNS* March 31,2017 Studies Required:SEPA Checklist Comment Period:There is a 14-day comment period for this MDNS. If you would like to comment on this Threshold Determination,written comments must be received prior to 5:00 p.m.on April 17.2017,The Responsible Official may incorporate any substantial comments into the MDNS. If the MDNS is substantially modified,it will be reissued for further public review. SEPA Responsible Official• Marc Hayes,Director of Community and Economic Development (Y)arch 31 , 201-7 - t=vfz- l_U a RG twAaS DATE SIGNATU NO f SEPA RESPONSIBLE OFFICIAL To Appeal a Decision: An agency or person may appeal the City's procedural compliance with WAC Chapter 197-11 (SEPA)for issuance of this MDNS.Appeal of the final MDNS must be made to the Hearing Examiner within 10 days of the date the MDNS is final(see WAC 197-11-390(2) (a)).The MDNS is a final MDNS when the City issues the land use permit.Appeal of the land use permit must be made to the Hearing Examiner within 14 days of the date the permit is issued. SEPA ENVIRONMENTAL CHECKLIST(WAC 197-11-960) [CHINOOK LUMBER] Purpose of checklist: The State Environmental Policy Act (SEPA), chapter 43.21C RCW, requires all governmental agencies to consider the environmental impacts of a proposal before making decisions. An environmental impact statement(EIS)must be prepared for all proposals with probable significant adverse impacts on the quality of the environment. The purpose of this checklist is to provide information to help you and the agency identify impacts from your proposal(and to reduce or avoid impacts from the proposal,if it can be done)and to help the agency decide whether an EIS is required. Instructions for applicants: This environmental checklist asks you to describe some basic information about your proposal. Governmental agencies use this checklist to determine whether the environmental impacts of your proposal are significant, requiring preparation of an EIS. Answer the questions briefly,with the most precise information known,or give the best description you can. You must answer each question accurately and carefully, to the best of your knowledge. In most cases, you should be able to answer the questions from your own observations or project plans without the need to hire experts. If you really do not know the answer, or if a question does not apply to your proposal, write "do not know" or "does not apply." Complete answers to the questions now may avoid unnecessary delays later. Some questions ask about governmental regulations, such as zoning, shoreline, and landmark designations. Answer these questions if you can. If you have problems,the governmental agencies can assist you. The checklist questions apply to all parts of your proposal, even if you plan to do them over a period of time or on different parcels of land. Attach any additional information that will help describe your proposal or its environmental effects. The agency to which you submit this checklist may ask you to explain your answers or provide additional information reasonably related to determining if there may be significant adverse impact. Use of checklist for nonproject proposals: Complete this checklist for nonproject proposals, even though questions may be answered "does not apply." IN ADDITION, complete the SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS(part D). For nonproject actions,the references in the checklist to the words"project," "applicant,"and"property or site"should be read as "proposal," "proposer,"and"affected geographic area,"respectively. A. BACKGROUND 1. lame of proposed project,if applicable: 2. Name of applicant• 3. Aodress and phone num r of applicant and contact person: /Sol XO A,6C , A//h�yllill/� 4. Date checklist prepared:�J ��/ 5. Agency requesting checklist: 6. Proposed timing or schedule(including phasing,if applicable)Are SEPA Checklist Page 1 of 9 Do you have any plans for future additions,expansion,or further activity related to or connected with this proposal? f yes,explain. 8. List any environmental information you know about that has been prepared,or will be prepared, directly related to this proposal. 6 fi�✓��.(biJ " CoMx�i•�cr,vL. ►f ++�L_ t2/,r j-rJ J kj,* 9. Do you know whether applications are pending for governmental approvals of other proposals directly affecting the property covered by your proposal? If yes,explain. f n 10. List any government approvals or permits that will be needed for your proposal,if known. 11. Give brief, complete description of your proposal, including the proposed uses and the size of the project and site. There are several questions later in this checklist that ask you to describe certain aspects of your proposal. You do not need to repeat those answers on this page. (Lead agencies may modify this form to include additional specific information on project description.) /Z"4- 14-20— 12. cation of the proposal. Give sufficient information for a person to understand the precise location of your proposed project, including a street address, if any, and section, township, and range, if known. If a proposal would occur over a range of area, provide the range or boundaries of the site(s). Provide a legal description,site plan,vicinity map,and topographic map,if reasonably available. While you should submit any plans required by the agency,you are not required to duplicate maps or detailed plans submitted with any permit applications related to this checklist. B. ENVIRONMENTAL ELEMENTS 1. Earth a. General description of the site(underline)' Flat, oiling,hilly,steep slopes,mountainous,other.. b. What is the steepest slope on the site(approximate percent slope) c. What general types of soils are found on the site(for example,clay,sand,gravel,peat,muck)? If you know the classification of agricultural soils,specify them and note any prime farmland. d. Are there surface indications or history of unstable soils in the immediate vicinity? If so,describe. e. Describe the purpose,type,and approximate quantities of any filling or grading proposed.Indicate source of fill. f. Could erosion occur as a result of clearing,construction,or use? If so,generally describe. g. About what percent of the site will be covered with impervious surfaces after project construction(for example, asphalt or buildings)? SEPA Checklist Page 2 of 9 h. Proposed measures to reduce or control erosion,or other impacts to the earth,if any: 2. Air a. What types of emissions to the air would result from the proposal (i.e., dust, automobile, odors, industrial wood smoke) during construction and when the project is completed? If any,generally describe and give approximate quantities if known. n(f b. Are there any off-site sources of emissions or odor that may affect your proposal? If so, generally describe. t4lr c. Proposed measures to reduce or control emissions or other impacts to air,if any: 3. Water a. Surface: i. Is there any surface water body on or in the immediate vicinity of the site (including year-round and seasonal streams, saltwater, lakes, ponds, wetlands)? If yes, describe type and provide names. If appropriate,state what stream or river it flows into. ' 1l ./ ii. Will the project require any work over, in, or adjacent to (within 200 feet) the described waters? If yes,please describe and attach available plans. iii. Estimate the amount of fill and dredge material that would be placed in or removed from surface water or wetlands and indicate the area of the site that would be affected. Indicate the source of fill material. iv. Will the proposal require surface water withdrawals or diversions? Give general description,purpose,and approximate quantities if known. v. Does the proposal lie within a 100-year floodplain? If so,note location on the site plan. A. Does the proposal involve any discharges of waste materials to surface waters? If so, describe the type of waste and anticipated volume of discharge. b. Ground: i. Will ground water be withdrawn, or will water be discharged to ground water? Give general description,purpose,and approximate quantities if known. I Describe waste material that will be discharged into the ground from septic tanks or other sources, if any (for example: Domestic sewage; industrial, containing the following chemicals. . . ; agricultural; etc.). Describe the general size of the system, the number of such systems, the number of houses to be served(if applicable), or the number of animals or humans the system(s)are expected to serve. c. Water runoff(including stormwater): SEPA Checklist Page 3 of 9 i. Describe the source of runoff (including storm water) and method of collection and disposal, if any (include quantities, if known). Where will this water flow? Will this water flow into other waters? if so,describe. ii. Could waste materials enter ground or surface waters? if so,generally describe. iii. Proposed measures to reduce or control surface,ground,and runoff water impacts,if any: 4. Plants a. Check or circle types of vegetation found on the site: ❑deciduous tree: alder,maple,aspen,other ❑evergreen tree: fir,cedar,pine,other ❑shrubs ❑grass ❑pasture ❑crop or grain ❑wet soil plants: cattail,buttercup,bullrush,skunk cabbage,other ❑water plants: water lily,eelgrass,milfoil,other ❑other types of vegetation b. What kind and amount of vegetation will be removed or altered? c. List threatened or endangered species known to be on or near the site. d. Proposed landscaping,use of native plants,or other measures to preserve or enhance vegetation on the site,if any: 5. Animals a. Circle any birds and animals which have been observed on or near the site or are known to be on or near the site: birds: hawk,heron,eagle,songbirds,other: mammals: deer,bear,elk,beaver,other: fish: bass,salmon,trout,herring,shellfish,other: b. List any threatened or endangered species known to be on or near the site. c. is the site part of a migration route? If so,explain. d. Proposed measures to preserve or enhance wildlife,if any: 6. Energy and natural resources a. What kinds of energy electri natural gas, oil, wood stove, solar) will be used to meet the completed project's energy needs? Describe whether it will be used for heating, manufacturing,etc. SEPA Checklist Page 4 of 9 b. Would your project affect the potential use of solar energy by adjacent properties? If so,generally describe. Or c. What kinds of energy conservation features are included in the plans of this proposal? List other proposed measures to reduce or control energy impacts,if any: 7. Environmental health a. Are there any environmental health hazards, including exposure to toxic chemicals, risk of fire and explosion, spill, or hazardous waste, that could occur as a result of this proposal? If so,describe. i. Describe special emergency services that might be requiredfi4� � ii. Proposed measures to reduce or control environmental health hazards,if any: b. Noise i. What types of noise exist in the area which may affect your project (for example: traffic,equipment,operation,other)? N�A- ii. What types and levels of noise would be created by or associated with the project on a short-term or a long-term basis (for example: traffic, construction, operation, other)? Indicate what hours noise would come from the site. M+✓�,'Mn L AID(S/, iii. Proposed measures to reduce or control noise impacts,if any: 8. Land and shoreline use a. What is the current use of the site and adjacent properties? b. Has the site been used for agriculture? If so,describe. c. Describe any structures on the site. d. Will any structures be demolished? If so,what? e. What is the current zoning classification of the site? f. What is the current comprehensive plan designation of the site? g. If applicable,what is the current shoreline master program designation of the site? h. Has any part of the site been classified as an"environmentally sensitive"area? If so,specify. SEPA Checklist Page 5 of 9 i. Approximately how many people would reside or work in the completed project? j. Approximately how many people would the completed project displace? k. Proposed measures to avoid or reduce displacement impacts,if any: 1. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans,if any: 9. Housing 0 a. Approx ately how many units would be provided,if any? Indicate whether high,middle,or low-income housing. b. Approximately how many units,if any,would be eliminated?Indicate whether high, middle,or low-income housing. c. Proposed measures to reduce or control housing impacts,if any: 10. Aesthetics NJ'J- a. What is the tallest height of any proposed structure(s),not including antennas;what is the principal exterior building material(s)proposed? b. What views in the immediate vicinity would be altered or obstructed? Proposed measures to reduce or control aesthetic impacts,if any: 11. Light and glare 0 V a. What type of light or glare will the proposal produce? What time of day would it mainly occur? b. Could light or glare from the finished project be a safety hazard or interfere with views? c. What existing off-site sources of light or glare may affect your proposal? d. Proposed measures to reduce or control light and glare impacts,if any: 12. Recreation P1V a. What designated and informal recreational opportunities are in the immediate vicinity? b. Would the proposed project displace any existing recreational uses? If so,describe. SEPA Checklist Page 6 of 9 c. Proposed measures to reduce or control impacts on recreation,including recreation opportunities to be provided by the project or applicant,if any: 13. Historic and cultural preservation a. Are there any places or objects fisted on,or proposed for,national,state,or local preservation registers known to be on or next to the site? If so,generally describe. b. Generally describe any landmarks or evidence of historic,archaeological,scientific,or cultural importance known to be on or next to the site. c. Proposed measures to reduce or control impacts,if any: 14. Transportation a. Identify public streets and highwa s serv' the site,and describe pr osed access to the existing street system. Show on site plans,if any. Z7 b. Is site currently served by public transit? If not,what is the approximate distance to the nearest transit stop? e. How many parking spaces would the completed project have? How many would the project eliminate? d. Will the proposal require any new roads or streets,or improvements to existing roads or streets,not including driveways? If so,generally describe(indicate whether public or private). ND D e. Will the project use(or occur in the immediate vicinity of)water,rail,or air transportation? If so,generally describe. N/� f. How many vehicular trips per day would be generated by the completed project?If known,indicate when peak volumes would occur. g. Proposed measures to reduce or control transportation impacts,if any: 15. Public services a. Would the project result in an increased need for public services(for example:fire protection,police protection,health care,schools,other)? If so,generally describe. fin T\A' b. Proposed measures to reduce or co trol direct impacts on public services,if any. 16. Utilities J f a. Circle util' ' ntly available at the sit . �electrici atur�ala �ater �sevic el�hone s ni sewer seppfics stem other. SEPA Checklist Page 7 of 9 b. Describe the utilities that are proposed for the project,the utility providing the service,and the general construction active on the site or in the immediate vicinity which might be needed. C. SIGNATURE The above are true and complete to the best of my knowledge. 1 understand that the lead agency is relying on them to make its ecision. -A Signatur . .......................'...../ ................._........................................................................................................ Date Submitted: .............. SEPA Checklist Page 8 of 9 D. SUPPLEMENTAL SHEET FOR NONPRO.WCT ACTIONS Because these questions are very general,it may be helpful to read them in conjunction with the list of the elements of the environment. When answering these questions,be aware of the extent the proposal or the types of activities likely to result from the proposal, would affect the item at a greater intensity or at a faster rate than if the proposal were not implemented.Respond briefly and in general terms. 1. How would the proposal be likely to increase discharge to water;emissions to air;production,storage,or release of toxic or hazardous substances;or production of noise? N l a. Proposed measures to avoid or reduce such increases are: 2. How would the proposal be likely to affect plants,animals,fish,or marine life? NI a. Proposed measures to protect or conserve plants,animals,fish,or marine life are: 3. How would the proposal be likely to deplete energy or natural resources? w! a. Proposed measures to protect or conserve energy and natural resources are: 4. How would the proposal be likely to use or affect environmentally sensitive areas or areas designated(or eligible or under study)for governmental protection;such as parks,wilderness,wild and scenic rivers,threatened or endangered species habitat,historic or cultural sites,wetlands,floodplains,or prime farmlands?Ple- a. Proposed measures to protect such resources or to avoid or reduce impacts are: 5. How would the proposal be likely to affect land and shoreline use,including whether it would allow or encourage land or shoreline uses incompatible with existing plans? All a- a. Proposed measures to avoid or reduce shoreline and land use impacts are: 6. How would the proposal be likely to increase demands on transportation or public services and utilities? 4141— a. Proposed measures to reduce or respond to such demand(s)are: 7. Identify,if possible,whether the proposal may conflict with local,state,or federal laws or requirements for the protection of the environment. Or SEPA Checklist Page 9 of 9 A-Background: #7—No future plans for additions or expansions related to this tank. Propane will be a product/service that we offer through our retail store on site to our existing customer base. #12- Physical street address: 21015 State Route 9 NE Arlington, WA 95223 phone (360)435-9900 The tank will sit just south of the main store building approximately 75 feet, East of Highway 9 approximately 200 feet, West of Olympic Place 125 feet, and North of the Plywood shed on the property 120 feet. The closest hazard will be a power pole and the pump on the tank will be just over 25 feet from the base of the pole. See Diagram attached. B-Environmental Elements: #1B-Steepest Slope approximately 4% #1C-Asphalt pavement over the majority of the site. #1D- No surface indications or history of unstable soils visible in the area. #1E- Not applicable #1F- Not applicable #1G-site will stay the same,just placing a tank on existing asphalt. #1H-Not applicable #2-Air—Entire section Not applicable #3-Water—A Surface—entire section, Not applicable #3-Water—B Ground—entire section, Not applicable #4-Plants— A—Check Deciduous Tree, Check Evergreen Tree, Check Shrubs. B- None C-None D-None #S-Animals- A—Circle Birds,songbirds, other(pigeons) A-Circle mammals, other(mice) B- None C- No D-None #7-Environmental Health B-Noise-ii store hours of operation are 7 am to 6 pm. #8-Land and shoreline use B-No C-Existing buildings on site will not change D-No H-No "environmentally sensitive" areas. I-No additional workers J-No displacement of people k-Not applicable I-Not applicable #13 Historic and cultural preservation A-None B-None C-Not applicable #14 Transportation B-Yes,transit stop within % mile. C-parking would not be impacted F-1 to 2 additional vehicle trips per day,would primarily be selling to existing customers that would be stopping at the store for other items. Peak volumes would be during working hours (7 am to 6 pm) G-Very limited additional traffic, no control needed at this time. COMMERCIAL MECHANICAL • 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 Replacement Alteration Project Address: �/,0 J7'1''!'� / Parcel#: Project D criptio f dYt �/� t�7) �C x.L�O Valuation: �� 41 Owner OIL L� Phone#: Address: 1(�z- �/T�a✓�Z City: _State: Zip: Email Address: i�►lozs - Contact Person: //UN ��N Phone Address: Cit /�'�//✓(r State: "11/zip: Email Address:M/MV*Az�l• h'��n1��, F,rr(n�-�• ( � �� Contractor Nam : /h�-� Phone#: Lip: Contractor Address: / /Yc,c� /(fW-- Cite=-f- �/�� Stat fo)-7/7� Email: /`f° / /rli�G i' �. � Contact Person: ') Contractor License Nu 1=_k(to �LL ExpiraqgD. l 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 AC(evaporator) PACKAGED UNIT UST AC(VRF) DRYER OTHER �� J�j�}yJ��z.-'/t(✓�L� I hereby certi that the bo information is corjj�ect and that the construction on, and the occupancy and the se of the above- J described pro rty will e c r #ncwith he Idws, III a d regulation of the State of Washing ton. V / Applicants Signa ure: '"' Date / Applicants Printed Name: tj FOR STAFF USE ONLY Permit# Accepted By Amount Received Receipt# Date Received 6/16LP Page 1 of 1 OPERATING PERMIT APPLICATION Department of Community& Economic Development City of Arlington• 18204 59th Ave NE•Arlington,WA 98223•Phone(360)403-3551 Part I Applicant/Building Informati'o1n�,. Applicant's Name: (�YII Al oC Applicant's Address4A>/S� 901-u I� Contact Person �,�/� ,,J� Telephone: ;1�y ��/• �/1 A dress of Premises for which Operating Permit is requested: Same as above ❑ Other(specify): Tax Parcel ID#: 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. Please indicate the type(s)of Operating Permit(s)requested by checking each applicable box. (If you require assistance, or would like more information, contact the City of Arlington Building Department at 360-403- 3551.) Manufacturing, 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): Revised 4/l/08 Page 1 of 4 Part H(con tW) ❑ Conducting 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 process(es) or activity(ies)to be conducted(attach additional sheets if necessary): ❑ Use of pyrotechnic devices in assembly occupancies(see Appendix C.)Describe the devices to be used and type of event(attach additional sheets if necessary): ❑ Aboveground Storage Tank(AST) (see Appendix D) ❑ Removal ❑ Decommissioning ❑ Temporary lank closure ❑ Changes in service ❑ Permanent tank closure Brief description: ❑ 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 description of structure and use: Cc: Fire Department Page 2 of 4 Part II(con tW) ❑ 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 the 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?❑ Yes ❑No Type: ❑Permanent❑ 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 I herby certify that the foregoing information(and all information in attached sheets, if any) is true and complete. Signature of Applicant or Authorized presentatives Signature Date 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 Permit): Additional Comments: (Attach additional pages if needed) Cc: Fire Department Page 4 of 4 OPERATING PERMIT APPLICATION Appendix A Hazardous Materials Storage Department of Community& Economic Development City of Arlington•18204 59th Ave NE-Arlington,WA 98223-Phone(360)403-3551 ■ An Operating Permit is required when a hazardous material listed in any of the categories in tables 5003.1.1 (1), 5003.1.1 (2), 5003.1.1 (3), or 5003.1.1 (4) of the Fire Code is manufactured,stored, or handled; and the quantity of such hazardous material exceeds the quantity listed in the applicable table. o This includes any building that is,whole or in part,a"Group W occupancy; is a pre-existing and non-conforming hazardous occupancy; or has outdoor use of,manufactures,and/or stores materials that exceed the tables for physical and/or health hazard. ■ An Operating Permit will not be issued until an inspection has been performed and establishes,to the satisfaction of the Fire Marshal,that the requirements of the Fire Code are satisfied; including provisions and requirements regarding manufacture, use,and storage,listed in Chapter 50 of the Fire Code. o A previous fire safety inspection will not wave this requirement. ■ Tests necessary to verify compliance with the Fire Code must be performed by the applicant,and the reports of such tests must be provided to the Fire Marshal. These tests and reports vary from product to product; however,they must include the following requirements: ❑Verification of inspection of the fire protection systems Verification of inspection of storage cylinders,tanks,or containers Presentation of Material Safety Data Sheets (MSDS) Verification of compliance with any other applicable State Agency Revised 9/2016 F 4 v Ask a in �- n 0 oa 0 meld DldwAlo 6 AMH o],OOZ .SZT 0 c c Y � G m L F- OJ G G O C, j O ry a > ti �I Date: 03/18/2026 Permit#: 1399 Permit Date: 03/28/2017 Review Date: 03/28/2017 Permit Type: COMMERCIAL MECHANICAL Review Type: COMMERCIAL MECHANICAL Target Date: 04/11/2017 Scheduled Time: 00:00 Completed Date: 03/29/2017 Description: approved with red lines. Review Status: Assigned To: z.Rick Karns Time In: 00:00 Time Out: 00:00 Hours: 0.0 Property Information Parcel#: 31051100400500 COOK INVESTMENTS NW COOK INVESTMENTS NW 18818 TELLER AVE STE 277 21015 STATE ROUTE 9 NE IRVINE, CA 92612 Zoning: 521 Lumber& Other Building MaterialsLot: Block: Permit#: 1399 Permit Date: 03/28/17 Permit Type: COMMERCIAL MECHANICAL Project Name: Chinook Lumber Applicant Name: Amerigas Propane Applicant Address: 4509 152nd Street NE Applicant, City, State, Zip: Marysville,WA 98271 Contact: MaryAnn Harding Phone: 360-591-4117 Email: maryann.harding@amerigas.com Scope of Work: Install 1000 gal LP dispenser Valuation: 15000.00 Square Feet: 0 Number of Stories: 0 Construction Type: Occupancy Group: ID Code: Permit Issued: 05/02/2017 Permit Expires: Form Permit Type: Status: LASERFICHE Assigned To: Launa Black Property Parcel# Address Legal Description Owner Name Owner Phone Zoning COOK 521 Lumber&Other 31051100400500 21015 STATE ROUTE 9 NE INVESTMENTS Building Materials NW Contractors Contractor Primary Contact Phone Address Contractor Type License License AmeriGas MaryAnn Harding 360-591-4117 4509 152nd Street MECHANICAL NE CONTRACTOR Inspections Date Inspection Type Description Scheduled Date Completed Date Inspector Status 03/19/2019 Inspection Propane Tank Install BUILDING Approved Plan Reviews Date Review Type Description Assigned To Review Status 03/28/2017 COMMERCIALMECHANICAL approved with red lines. z.Rick Karns Fees Fee Description Notes Amount Building Plan Review Table 4-2 $230.54 Building Permit Table 4-1 $354.68 Processing/Technology $25.00 State Surcharge- 1st DU Residential- 1st Unit $4.50 Total $614.72 Attached Letters Date Letter Description 04/24/2017 Building Permit Payments Date Paid By Description Payment Type Accepted By Amount 04/02/2017 MaryAnn Harding 64115484 cc $230.54 04/28/2017 MaryAnn Harding 64464373 cc $384.18 Outstanding Balance $0.00 Notes Date Note Created By: 04/17/2017 SEPA MDNS Decision is approved.A copy of the MDNS has been attached and is also under Amy Rusko PLN#333.AR 03/28/2017 Cannot be issued until SEPA is complete-1p Launa Black Uploaded Files Date File Name 05/02/2017 2257894-1399 Issued Permit.pdf 04/17/2017 2220890-Chinook Signed MDNS.pdf 03/28/2017 2179895-CHINOOK LUMBER SEPA 03282017.pdf 03/28/2017 2179871-CITY OF ARLINGTON PERMIT CHINOOK LUMBER 03 28 2017.pdf