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HomeMy WebLinkAbout1205 E 5th St_BLD1526_2026 �•1Y o� COMMERCIAL MECHANICAL • PERMIT APPLICATION r 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, IFAPPLICABLE. Type of Permit: 0 New Installation ❑ Replacement U Alteration Project Address 12-OS F- Parcel#: C lOG__ G lad Project Description: 2 L�f" \ab'on Valuation: SS Owner: cat L\-D O w Phone#: Address: 12Q5 5_bl� 6t City: State: lR Zip: 9�37.23 Email Address: 1VQ\ _ Contact Person: Ma& Lee i11 Phone#: z403-81ct5 Address: ? Q3 " �°1 `pr IV City: A C\'\n2ja YL State: �4 R _Zip: 9 6223 Email Address: _ \U b`�l d !Q (wyaA LOyM Contractor Name: Mom Phone#: Contractor Address: City State: Zip: Email: Contact Person.- Contractor License Number: Expiration: 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 I hereby certify that the above information is correct and that the constriction on, and the occupancy and the use of the above- described property will be in accordance with the la les and regulation of the State of Washington. _ Applicants Signature: L& `` _ Date Applicants Printed Name: E` �. FOR STAFF USE ONLY Received Pe it# Ac6*tSfd By Amount Received Receipt# Dacfvgi Z017 8116LP Page 1 of 1 COMMERCIAL MECHANICAL PRESSURE PIPING INFORMATION Department of Community& Economic Development City of Arlington•.18204 59th Ave NE•Arlington, WA 98223• Phone(360)403-3551 If gas piping will be installed, this form is required in addition to a Commercial Mechanical Permit Application Pipe Material: V, 4�9- Inlet Pressure: 15 Pressure Drop: Specific Gravity: Pressure Piping Schematic Show Pipe Size(s)and Length(s)from meter to all appliances. ❑ Scale or Not to Scale NOTE: any interior pressure regulators must be indicated NOTE: drip legs/sediment traps are required at all appliances unless integrated in the listed appliance I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the above- descn ed property will be in accordance with the laws, rules and regulation of the State of Washington. Applicants Signature Date Mas--IL Lc� Received Print Applicants Name JUN 2 8 Z017 J CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:1205 E 5th Street Permit#:1526 Parcel#:31050100301200 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:OBERLY CALVIN/MISHA/CAMPBELL Name:Mark Lee Name: MIKE/CAMPBELL Address:3405 172nd Street NE,Unit 5-214 Address:22803 19th Drive NE Address: City,State Zip:ARLINGTON,WA 98223-1118 City,State Zip:Arlington,WA 98223 City,State Zip:, Phone: Phone:360-403-8195 Phone: MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name:Mark Lee Name: Address:22803 19th Drive NE Address: City,State,Zip:Arlington,WA 98223 City,State,Zip: Phone:360-403-8195 Phone: LIC#: EXP- LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Residential Mechanical CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: 1 OCC GROUP: BUILDINGS: 1 OCC LOAD: PERMIT APPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY; NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBC110/IRC110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City o rh on must be rep rted on your sales tax return form and coded' f. lington#3101. ` t,CC— Lim / ,) Si nature Print Name Date a eased By Date CONDITIONS Pressure test inspection THIS PERMIT AUTHORIZS ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION. PERMIT FEES Date Description Fee Amount 6/28/2017 Gas Outlets Base Fee 1 to 5 $10.00 6/28/2017 Mechanical Permit Base Fee $25.00 6/28/2017 Processing/Technology Fee $25.00 Total Due: $60.00 Total Payment: $0.00 Balance Due: $60.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 42 PHONE; (360) 403-3551 BUILDING PERMIT Address:1205 E 5th Street Permit#:1526 Parcel#:31050100301200 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:OBERLY CALVIN/MISHA/CAMPBELL Name:Mark Lee Name: M1KE/CAMPBELL Address:3405 172nd Street NE,Unit 5-214 Address:22803 19th Drive NE Address: City,State Zip:ARLINGTON,WA 98223-1118 City,State Zip:Arlington,WA 98223 City,State Zip:, Phone: Phone:360-403-8195 Phone: MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name:Mark Lee Name: Address:22803 19th Drive NE Address: City,State,Zip:Arlington,WA 98223 City,State,Zip: Phone:360-403-8195 Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Residential Mechanical CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: 1 OCC GROUP: BUILDINGS: 1 OCC LOAD: PERMIT APPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY; NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBC110/IRC110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City o lin ton must be rep rted on your sales tax return form and coded C' f rlington#3101. J 0419 M� k 7-i - 4d A - Siknature Print Name Date eleased By Date CONDITIONS Pressure test inspection THIS PERMIT AUTHORIZS ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION. PERMIT FEES Date Description Fee Amount 6/28/2017 Gas Outlets Base Fee 1 to 5 $10.00 6/28/2017 Mechanical Permit Base Fee $25.00 6/28/2017 Processing/Technology Fee $25.00 Total Due: $60.00 Total Payment: $0.00 Balance Due: $60.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon COMMERCIAL MECHANICAL • PERMIT APPLICATION Ll 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 F1 Replacement Alteration Project Address: 12l3.5 F_ ,5 St, Parcel#: X's 01003012_06 Project Description: NAUc;�i1 GGs LIYIQ. Valuation: 4.5-S Owner: Tg6IJA Cam lew Phone#: Address: I Z06 E 5-b` 5t- City:_�� Iln��11 State: W R Zip: �3Z23 Email Address: tAanQ Contact Person: Mar-L L_y- AI Phone#:(3(d 4403-81cJ5 Address: ? 03 _ �°� r A City:A 0 1nPJan State: W n—Zip: 'l b92Z3 Email Address: 'V1u)0r-I Aca 2 Amca�\ (_O`(Y\ Contractor Name: I V©( Phone#: Contractor Address: City: State: Zip: Email: Contact Person: Contractor License Number: Expiration: _ 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 I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the above- described property will be in accordance with the la ules and regulation of the State of Washington. / Applicants Signature: Date / Applicants Printed Name: cc, v �1 FOR STAFF USE ONLY Received ('emit# Acc t d By Amount Received Receipt# Dat4 W.,Cgv&^^" 6/16LP Page 1 of 1 5 i ■ L' �I■ I 1 . 1 r■ �r 7\ 1 I �w ■ 1 11' 1 ■ I11 II i1 _ w 11 1 ,, ■A I •. I r 1 r,• 1 1 1 2 1 1 1 ► - T1 1 ff - 1 I I _1 ■ 1 •� L l COMMERCIAL MECHANICAL PRESSURE PIPING INFORMATION Department of Community& Economic Development City of Arlington•.18204 59th Ave NE •Arlington, WA 98223• Phone(360)403-3551 If gas piping will be installed, this form is required in addition to a Commercial Mechanical Permit Application Pipe Material:ac)�) - ti j�� Inlet Pressure: Pressure Drop: Specific Gravity: Pressure Piping Schematic Show Pipe Size(s)and Length(s)from meter to all appliances. ❑ Scale or Not to Scale NOTE: any interior pressure regulators must be indicated NOTE: drip legs/sediment traps are required at all appliances unless integrated in the listed appliance l 6" I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the above- descri ed property will be in accordance with the laws, rules and regulation of the State of Washington. act f-.Cs- C-Z 7- 0 Applicants Signature Date Nlac4 L'ec Received Print Applicants Name JUN 2 8 Z017 Permit#: 1526 Permit Date: 06/28/17 Permit Type: RESIDENTIAL MECHANICAL Project Name: Campbell Applicant Name: Mark Lee Applicant Address: 22803 19th Drive NE Applicant, City, State, Zip: Arlington,WA 98223 Contact: Mark Lee Phone: 360-403-8195 Email: flybridge25@gmail.com Scope of Work: Install gas line Valuation: 0.00 Square Feet: 0 Number of Stories: 0 Construction Type: Occupancy Group: ID Code: Permit Issued: 06/28/2017 Permit Expires: Form Permit Type: Status: COMPLETE Assigned To: Launa Black Property Parcel# Address Legal Description Owner Name Owner Phone Zoning 111 Single Family 31050100301200 1205 E 5TH ST OBERLY/CAMPBELL Residence- Detached Plan Reviews Date Review Type Description Assigned To Review Status 06/28/2017 RESIDENTIAL z.Rick Karns MECHANICAL Fees Fee Description Notes Amount Gas Piping/Units Enter#of units $10.00 Mechanical Base Permit Fee $25.00 Processing/Technology $25.00 Total $60.00 Attached Letters Date Letter Description 06/28/2017 Building Permit Payments Date Paid By Description Payment Type Accepted By Amount 06/28/2017 Mark Lee 65321614 cc $60.00 Outstanding Balance $0.00 Uploaded Files Date File Name 06/28/2017 2406844-1526 Issued Permit.pdf 06/28/2017 2406099-1526 Application.pdf