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HomeMy WebLinkAbout116 E Fifth Street_BLD1714_2026 ,�Y o COMMERCIAL REMODEL �i PERMIT APPLICATION ��G�O 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 PLANS, TWO(2)SETS OF SPECIFICATIONS, TWO(2) SETS OF STRUCTURAL CALCULATIONS, ONE(1)SETS OF NREC ENERGY CODE APPLICATIONS AND ONE(1) OCCUPANTS'S STATEMENT OF INTENDED USE. Type of Permit: Commercial Remodel ( ) Commercial Addition ( ) Tenant Improvement Project Address: ,�� r ��M ST Parcel ID#: Project Description ft#16bML FAQ, NEW.) "/Q&V7_ Legal Description Project Valuation: ooG#90 Owner: Phone Number: Address: City. State: Zip Code: Contact Person: Sko*,� k C( 4� Phone Number: Cell Phone E-mail: Address: City: State: Zip Code: Contractor: r'11 F1,Tr r:- Phone Numbe Address: Zq 6 Z3 3 RD/9-�/�1'+=,t,�A).En city: S AIt woo t� State: �/4, zip Code: 98 21 2 Contractor's License Number: J !(d/� ' 171 b6 Expiration: 11" N— 2017 Plumbing Contractor: Phone Number: Address: City: State: Zip Code Contractor's License Number: Expiration Mechanical Contractor: Phone Number: Address: City State: Zip Code: Contractor's License Number: Expiration: REV 2015 Page 6 of 7 COMMERCIAL REMODEL ���10 PERMIT APPLICATION Department of Community& Economic Development City of Arlington • 18204 59th Ave NE •Arlington, WA 98223 • Phone (360)403-3551 Project Name/Tenant DTaAM OLKRRPTY Site Address /( . F_ x1h S• Bldg./Unit/Suite IBC Construction Type IBC Occupancy Type Description of Use 13nwexy 4 Building Square Footage /.4= $9 9l: 4 Number of Stories / Square Footage per Floor Will there be any installation, modification or removal of the following? (Check all that apply) ❑ Automatic fire extinguishing systems ❑ Compressed gas systems ❑ Fire alarm and detection systems ❑ Fire pumps ❑ Flammable and combustible liquids(tanks, piping etc...) ❑ Hazardous materials ❑ High piled/rack storage ❑ Industrial ovens/furnace ❑ Private fire hydrants ❑ Spraying or dipping operations ❑ Standpipe systems ❑ Temporary membrane structure,tents(>200sq ft)or canopies(>400 sq ft) Provide details on any of the above checked items: Installation,changes,modifications or removal of any of the above may require additional submittals, information,or permits during the plan review or construction process. 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 laws, rules and regulation of the State of Washington. App ants Signature _ 2qZ1 7- Print Applicants Name Date FOR STAFF USE ONLY Received OCT 2 4 2017 Permit# Accepted By Amount Received Receipt# Date Received REV 2015 Page 7 of 7 V.� COMMERCIAL REMODEL ING�o PERMIT APPLICATION Department of Community& Economic Development City of Arlington • 18204 59th Ave NE •Arlington, WA 98223 • Phone(360)403-3551 k) Provide details and assembly numbers for any fire resistive assemblies. 1) Indicate on the plans all rated walls, doors,windows and penetrations. m) Provide a legend that distinguishes existing walls,walls to be removed and new walls 3. ❑ Reflected Ceiling Plan a) Plan view 118"minimum scale. Details a minimum'/4-inch scale. b) Provide ceiling construction details c) Provide suspended ceiling details complying with IBC 803.9.1.1. Show seismic bracing details. d) Show the location of all emergency lighting and exit signage. e) Detail the seismic bracing of the fixtures. f) Include a lighting fixture schedule. 4. ❑ Framing Plan a) Specify the size, spacing, span and wood species or metal gage for all stud walls. b) Indicate all wall, beam and floor connections. c) Detail the seismic bracing for all walls. d) Include a stair section showing rise, run, landings, headroom, handrail and guardrail dimensions. 5. ❑ Storage Racks (if applicable) a) Structural calculations are required for seismic bracing of storage racks eight feet or greater in height. b) Eight feet or less, show a positive connection to floor or walls. NOTE: High pile storage shall meet the requirements of current International Building and Fire Codes. C. ❑ SPECIAL INSPECTION 1. Where special inspection is required by IBC 1704,the registered design professional in responsible charge shall prepare a special inspection program that will be submitted to the City of Arlington and approved prior to issuance of the building permit to comply with IBC 106.1. D. ❑ WASHINGTON STATE ENERGY CODE 1. One(1)completed Washington State Non-Residential Energy Code Envelope Summary forms. E. OCCUPANT'S STATEMENT OF INTENDED USE 1. The Occupant's Statement of Intended Use form shall be completely filled out and may require the submittal of a Hazardous Materials inventory Statement(HMIS). Contact the Arlington REV 2015 Page 4 of 7 �`- COMMERCIAL REMODEL PERMIT APPLICATION Department of Community& Economic Development City of Arlington • 18204 59th Ave NE •Arlington, WA 98223 • Phone(360)403-3551 A. FEES DUE AT TIME OF PERMIT ISSUANCE B. CODES The City of Arlington currently enforces the following International Codes 1. 2015 International Building Code(IBC) 2. 2015 International Residential Code(IRC) 3. 2015 International Mechanical Code(IMC) 4. 2015 International Fuel Gas Code(IFGC) 5. 2015 International Fire Code(IFC) 6. 2015 International Plumbing Code(IPC) 7. 2015 International Property Maintenance Code(IPMC) 8. 2015 International Existing Property Code(IEBC) 9. 2015 Washington State Energy Code(WESC) 10 2009 Accessible&Usable Buildings and Facilities(ICC/ANSI 1417.1) Washington State Amendments 1. WAC 51-50 Washington State Building Code 2. WAC 51-51 Washington State Residential Code 3 WAC 51-52 Washington State Mechanical Code 4. WAC 51-54 Washington State Fire Code 5. WAC 51-56&51-57 Washington State Plumbing Code and Standards 6. WAC 51-11 Washington State Energy Code 7. WAC 296-46B Electrical Safety Standards,Administration, and Installation C. CITY OF ARLINGTON DESIGN REQUIREMENTS Design Wind Speed: 85 miles per hour(Exposure C) Ground Snow Load: 25 pounds per square foot Seismic Zone: D2 Rainfall: 2 inches per hour for roof drainage design. Frost Line Depth: 12 inches Soil Bearing Capacity: 1,500 psf unless a Geo-Technical Report is provided. (IBC Table 1804.2& IRC R401.4.1) D. PLANS AND DRAWINGS Submit two(2)complete sets of drawings and plans. Drawings and plans must be submitted on minimum 18"X 24", or maximum 30"X 42"paper.All sheets are to be the same size and sequentially labeled. Plans are required to be clearly legible,with scaled dimensions, in indelible ink, blue line, or other professional media. Plans will not be accepted that are marked preliminary or not for construction,that have red lines, cut and paste details or those that have been altered after the design professional has signed the plans. Please Note:A separate submittal of plans is required for each building or structure. REV 2015 Page 2 of 7 �•�y r�s. COMMERCIAL MECHANICAL PERMIT APPLICATION IN G`�O 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: 'S-'*1 ST Parcel#: Project Description: T--bp- 'New 77114k T Valuation: Owner: Phone#: Address: City: State: Zip: Email Address: Contact Person Phone#: Address: City: State: Zip: Email Address: G T� .�q Contractor Name: z_ I hYt�(2 Dr4- �/ Phone#:L?_6 � l5 - rC� 29 2, Contractor Address: 7.9 b 2.3 3 Rz�' AVfr /v. City: &A A/�State:LJ&Zip: r�� Email: .It/y`�R®4 /TT'c4��n Ma►i e_ 'CAA'\ Contact Person: .TAi , �/// Contractor License Number: QJ 4&(1�.'�' K`' / 7/'Do Expiration: /�- /'�1 � � 1 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 e-laws, riTe'sYnd latio of the State of Washington. Applicants Signature: _ / Date ID-24— ?Z1 Applicants Printed Name: " 1 �J FOR STAFF USE ONLY Received / �n � Permit# Accept Amount Received Receipt# Date �ivl` 6/16LP Page 1 of 1 COMMERCIAL PLUMBING � 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 TWO (2) SETS OF FIXTURE SPECIFICATIONS (CUT SHEETS). CALCULATIONS ARE REQUIRED FOR GREASE INTERCEPTOR IF APPLICABLE. Type of Permit: 0 New Installation 0 Addition/Alteration 0 Industrial Project Address: r- TT,-%Oqr Parcel ID#: Lot#: Subdivision: Project Description: Mtzy RE- SI►J11v 461411k&aluation Owner: Phone Number: Address: City: State: Zip Code: Contact Person: Phone Number Cell Phone. E-mail: Address: --�- City: State: Zip Code: c� p Contractor: �J ►►v�. G� r' Phone Number:(2©(6J Cell Phone: , Z�S�}2 j Z Email: aRO�ri t rr�, ( ,&'4 L. Address:_M V 2�.�AVA Al- M, City: �1 State: t o Zip Code, Contractor License Number: ,J ..J 14 X171b Q= Expiration Date: /4 2017 Please indicate number of fixtures: Water Closet Floor Sink Sump Hose Bibb Miscellaneous Lavatory Laundry Tub Washer Water Heater Grease Trap Urinal Interceptor Sink Med Gas Drinking Fountain Floor Drain Dishwasher Backflow Shower _ Other Received OCT 2 5 2017 � 171V 6/16LP Page 2 of 3 `� °^ COMMERCIAL PLUMBING PERMIT APPLICATION Department of Community&Economic Development City of Arlington • 18204 59th Ave NE •Arlington, WA 98223 • Phone(360)403-3551 PROPOSED BUILDING USE ❑ New Commercial ❑ Restaurant ❑ Automotive Based V] Commercial Addition/Alteration ❑ Office ❑ Machine Shop ❑ Industrial ❑ Medical Other: CROSS CONNECTION Please check all appliances that are proposed or are permanently connected to the water supply. 13 Ice Machine ❑ Dialysis Equip. ❑ Air washers ❑ Swimming ❑ Fire Sprinkler Pools Coffee ❑ Steam Sprinkler Hydrotherapy Equip. ❑ ❑ Hot Tub/Spa ❑ Urn/Espresso Generators w/chemicals ❑ Carbonated Bev. ❑ Dental Equip. ❑ Dye Vats ❑ Aquarium ❑ Lawn Irrigation ❑ Fume Hoods ❑ Laboratory Equip. ❑ Pressure ❑ Decorative ❑ Well on Washers Fountain property ❑ Degreasers ❑ Autoclave/Sterilizers ❑ Cooling Towers ❑ Other: WASTEWATER DISCHARGE 1. Does the plumbing system currently have a grease interceptor? ❑ Yes ❑ No ❑ Don't Know Date grease trap/interceptor was last cleaned (provide service record): 2. Does the plumbing system currently have an oil/water separator? ❑ Yes ❑ No ❑ Don't Know 3. Date oil/water separator was last cleaned (provide service record): 4. Is water used in the business process(washing, rinsing, cooling)? ❑ Yes ❑ No ❑ Don't Know 5. Does your business require a NPDES permit? ❑ Yes ❑ No ❑ Don't Know 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 in accordappA4 e laws ules nd regulation of the State of Washington. _Zq" �7 pplicants Si nature Date E177- Print Applicants Name FOR STAFF USE ONLY Permit# Accepted By Amount Received Receipt# Date Received 6/16LP Page 3 of 3 CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360) 403-3551 BUILDING PERMIT Address: 116 E Fifth Street Permit#: 1714 Parcel#:portion of00529900800102 Valuation: 15000.00 OWNER APPLICANT CONTRACTOR Name:Widmark Family Trust Name:Jim Proffitt Name:Jim Proffitt Address:3206 82nd Drive NE Address:29623 3rd Avenue NE Address:29623 Third Ave NE City,State Zip:Marysville,WA 98270 City,State Zip:Stanwood,WA 98292 City,State Zip:Stanwood,WA 98292 Phone: Phone:206-295-9292 Phone:206-295-9292 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 Alteration CODE YEAR: 2015 STORIES: I CONST.TYPE: DWELLING UNITS: 0 OCC GROUP: BUILDINGS: I OCC LOAD: PERMIT APPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY;NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBC 1 I0/IRC 110. SALES TAX NOTICE:Sales t x relating to construction and construction materials in the City of Arlin op s don your sales tax return form ed City 6 Arling m#3 / ure Print Name Date r,/Lol)relelrsed4fV V Date CONDITIONS See red lined plans. 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 11/2/2017 Building Permit Fee $354 68 11/2/2017 Building Plan Review Fee $230.54 11/2/2017 Processing/Technology Fee $25.00 11/2/2017 State Building Code Surcharge Fee $4.50 I Total Due: S614.72 Total Payment: $0.00 Balance Due: $614.72 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address: 116 E Fifth Street Permit#: 1714 Parcel#:portion of00529900800102 Valuation: 15000.00 OWNER APPLICANT CONTRACTOR Name:Widmark Family Trust Name:Jim Proffitt Name:Jim Proffitt Address:3206 82nd Drive NE Address:29623 3rd Avenue NE Address:29623 Third Ave NE City,State Zip:Marysville,WA 98270 City,State Zip:Stanwood,WA 98292 City,State Zip:Stanwood,WA 98292 Phone: Phone:206-295-9292 Phone:206-295-9292 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 Alteration CODE YEAR: 2015 STORIES: I CONST.TYPE: DWELLING UNITS: 0 OCC GROUP: BUILDINGS: I OCC LOAD: PERMIT APPROVAL l 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/IRC1 l0. SAL S TAX NOTICE:Sales tax relating to construction and construction materials in the City of Arlin OR t�a tax return form ed City 6 Arling n#3 2-IC11 ure Print Name Date Y//L-'ftelcl(scd4lv V Date CONDITIONS See red lined plans. 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 11/2/2017 Building Permit Fee $354.68 11/2/2017 Building Plan Review Fee $230.54 11/2/2017 Process ingfTechnology Fee $25 00 11/2/2017 State Building Code Surcharge Fee $4.50 Total Due: $614.72 Total Payment: $0.00 Balance Due: $614.72 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 Permit Information Date 10/26/2017 Permit Number 1714 Project Name Proffitt Applicant Name Jim Proffitt Applicant Address 29623 3rd Avenue NE City, State,Zip Stanwood,WA 98292 Contact Jim Proffitt Phone 206-295-9292 Email jimproffitt@gmail.com Permit Type Commercial Alteration Site Address 116 E Fifth Street Valuation 15000.00 Status Applied Permit Issued Permit Expires Square Feet 0 Type of Construction/Occupancy Load Number of Stories 1 Proposed Use Remodel to walls plumbing and mechanical Assigned To Launa Peterson Property Parcel Address Subdivision Lot Owner portion of 00529900800102 1116 E Fifth Street lWidmark Family Trust Notes Date Note 10/26/2017 jAdding 2 sinks,dishwasher and cooler. Uploaded Files Upload File Date File Uploaded By I 10/26/2017 1:32:55 PM 11114 npplicamon.ndf Peterson,Launa .•�X I- 'J 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 F7 Replacement Alteration 711 Project Address: ��o Parcel#: Project Description: NEW 77&tJhAY7- Valuation: Owner:_ Phone#: Address: City: State: Zip: Email Address: Contact Person Phone#: Address: City: State: Zip: Email Address: �-- �q Contractor Name: +J !/Y� ri'0 / Phone#:CZ(5 � C l S - ro 29 2, Contractor Address: 7i3 3 W-0 AVir Al. E. City: State: /m Zi 315 2p Email: to enMAi,.. r CAM Contact Person: I41�1 Contractor License Number: Z7746MT: + 17114 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-+awS. 0e nd latiog of the State of Washington.Applicants Signature - Date ) 2-j(� �7 r Applicants Printed Name: FOR STAFF USE ONLY Permit# Acceptifd Wy Amount Received Receipt# Date'96c6ivdd 6/16LP Page 1 of 1 I ' I Y O� COMMERCIAL REMODEL �,�lj�res�o PERMIT APPLICATION Department of Community& Economic Development City of Arlington • 18204 59th Ave NE •Arlington, WA 98223 • Phone (360)403-3551 The building permit does not include any mechanical, electrical, plumbing or fire sprinkler/alarm work. These permits are issued separately. Mechanical, electrical, plumbing, or fire sprinkler/alarm permits require a separate permit application and may also require separate plan review. Please note that any tenant improvement work in a space that involves food handling or preparation requires Snohomish County Health District approval before the permit can be issued. You must provide the Permit Center a copy of the approval letter or the approved plans. Contact the Snohomish County Health District at(425) 339-5250 with any questions or for more information. An intake appointment is required for all large Tenant Improvement Building Permit Applications. To determine if your project requires an intake appointment, to schedule an appointment or to ensure that you have the most current information, please contact the City of Arlington Permit Center at(360)403-3551 or by email to ced .arlingtonwa.gov Application by courier or mail will not be accepted. Incomplete applications will not be accepted. I acknowledge that all items designated as submittal requirements must accompany my Building Permit Application to be considered a complete submittal. REV 2015 Page 5 of 7 COMMERCIAL REMODEL 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 PLANS, TWO(2) SETS OF SPECIFICATIONS, TWO(2)SETS OF STRUCTURAL CALCULATIONS, ONE(1) SETS OF NREC ENERGY CODE APPLICATIONS AND ONE(1) OCCUPANTS'S STATEMENT OF INTENDED USE. Type of Permit: Commercial Remodel ( ) Commercial Addition ( ) Tenant Improvement Project Address: /= ,' 14 ;S'j' Parcel ID#: Project Description: aMbt L FbA, A)3(J Z-:6AAn— Legal Description: Project Valuation: ISOmD 0 00 Owner: Phone Number: Address: ►,,� City State: Zip Code: Contact Person: ['L mil- k C(I�W g fr,� Phone Number: Cell Phone: E-mail: Address: City State: Zip Code: Contractor: -1 7-1 ,�••'� Phone Number: Address Zit 6 n 3 RD AV8.�A/,[F. city:_�AI wca� State: &J14, Zip Code: g9 21?2 Contractor's License Number: � T�f dM_T, * 17I b6 Expiration //— ly— 2017 Plumbing Contractor: Phone Number: Address: City: State: Zip Code: Contractor's License Number: Expiration Mechanical Contractor: Phone Number: Address: City State: Zip Code: Contractor's License Number: Expiration: Received OCT 2 5 20'h' REV 2015 Page 6 of 7 COMMERCIAL REMODEL PERMIT APPLICATION Department of Community& Economic Development City of Arlington • 18204 59th Ave NE•Arlington, WA 98223 • Phone (360)403-3551 Project Name/Tenant LQu�T711,. ►�'X�=IT' Df=3RP% uR" Site Address //(a S1 Bldg./Unit/Suite IBC Construction Type IBC Occupancy Type 2 Description of Use �,?'Rzwexy �xl&w-- 0;4g t u.,'e. Building Square Footage 45.2 SQ�7', 4 Number of Stories Square Footage per Floor 150 Will there be any installation, modification or removal of the following? (Check all that apply) ❑ Automatic fire extinguishing systems ❑ Compressed gas systems ❑ Fire alarm and detection systems ❑ Fire pumps ❑ Flammable and combustible liquids(tanks, piping etc...) ❑ Hazardous materials ❑ High piled/rack storage ❑ Industrial ovens/furnace ❑ Private fire hydrants ❑ Spraying or dipping operations ❑ Standpipe systems ❑ Temporary membrane structure,tents(>200sq ft)or canopies(>400 sq ft) Provide details on any of the above checked items: Installation,changes,modifications or removal of any of the above may require additional submittals, information,or permits during the plan review or construction process. 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 laws, rules and regulation of the State of Washington. App' an�S�ignat�ure .fir /"T - -/4� 2q-z/ 7 Print Applicants Name Date FOR STAFF USE ONLY OCT 2 4 2017 Permit# Accepted By Amount Received Receipt# Date Received REV 2015 Page 7 of 7 ii .. � .. � i i I � � i COMMERCIAL PLUMBING PERMIT APPLICATION INC' 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 TWO (2) SETS OF FIXTURE SPECIFICATIONS (CUT SHEETS). CALCULATIONS ARE REQUIRED FOR GREASE INTERCEPTOR IF APPLICABLE. Type of Permit: ❑ New Installation ❑ Addition/Alteration ❑ Industrial Project Address: F_- J "2r Parcel ID#: Lot#: Subdivision: Project Description: MLwi R_ SI W< 1,OQATAM&aluation: Owner: Phone Number: Address: City: State: Zip Code: Contact Person: Phone Number: Cell Phone: E-mail: Address: —� City: State: Zip Code: q Contractor: r -d, �►M. G� Phone Number:(ZO( ) 2 15'9.S-5? . Cell Phone 12� 4�O') Z9S 9'2 1 Z Email �ROfi�t lT�(�, 49J ,4L Qom, Address: 26 2- 6.170 AV;A /J• 1 City: State: Zip Code:: Contractor License Number:_,.,,► .,J � ��7��GQ Expiration Date: Please indicate number of fixtures: Water Closet Floor Sink Sump Hose Bibb Miscellaneous Lavatory Laundry Tub Washer Water Heater Grease Trap Urinal Interceptor Sink Med Gas Drinking Fountain Floor Drain Dishwasher �_ Backflow Shower Other Received OCT 2 5 2017 'A b 17`V 6/16LP Page 2 of 3 A COMMERCIAL PLUMBING M PERMIT APPLICATION ��LING10 Department of Community&Economic Development City of Arlington • 18204 59th Ave NE•Arlington,WA 98223 • Phone (360)403-3551 WHEN is a PLUMBING PERMIT REQUIRED? The City of Arlington requires a plumbing permit before a plumbing system or fixture is installed, altered, or remodeled. This also includes replacement of a Hot Water Tank. The City of Arlington does not require a permit to stop leaks or clear stoppages, unless the piping being repaired is altered or replaced. PLUMBING PLAN REVIEW IS REQUIRED FOR THE FOLLOWING PROJECTS 1. New Commercial Buildings 2. New Multi-Family Buildings 3. Roof Drains and Overflow Systems 4. Tenant Improvements 5. Installation of Medical Gas Systems 6. Installation of Commercial Kitchen's and Deli's 7. Installation of Grease Traps 8. Installation of Grease Interceptors 9. Installation of Sumps 10. Installation of Cross Connection Backflow Devices SUBMIT TWO (2) COPIES OF THE FOLLOWING FOR PLUMBING PLAN REVIEW: ❑ Plumbing plans or drawings. (Minimum plan size is 18" X 24" scale, %" scale for details.) ❑ Provide one set of plumbing drawings maximum size 11" X 17" ❑ Size of sanitary and potable water systems. ❑ Location, type and specifications (cut sheets) of proposed fixtures and equipment. ❑ Riser diagram of waste and vent, potable water and rain water systems, including sizes. ❑ Medical gas piping riser diagram indicating type of gas, storage room and size of piping. ❑ Location and type of all backflow assemblies for each fixture. I hereby certify that I have read and examined this application and know the same to be true and correct and I am authorized to apply for this permit. 6/16LP Page 1 of 3 ` COMMERCIAL PLUMBING o� PERMIT APPLICATION tjNC'� Department of Community&Economic Development City of Arlington • 18204 59th Ave NE •Arlington, WA 98223 • Phone(360)403-3551 PROPOSED BUILDING USE ❑ New Commercial ❑ Restaurant ❑ Automotive Based V3 Commercial Addition/Alteration ❑ Office ❑ Machine Shop ❑ Industrial ❑ Medical ID Other: CROSS CONNECTION Please check all appliances that are proposed or are permanently connected to the water supply. ❑ Ice Machine ❑ Dialysis Equip. ❑ Air washers ❑ Swimming ❑ Fire Sprinkler Pools ❑ Coffee Steam Sprinkler Urn/Espresso ❑ Hydrotherapy Equip. ❑ Generators ❑ Hot Tub/Spa ❑ w/chemicals ❑ Carbonated Bev. ❑ Dental Equip. ❑ Dye Vats ❑ Aquarium ❑ Lawn Irrigation ❑ Fume Hoods ❑ Laboratory Equip. ❑ Pressure ❑ Decorative ❑ Well on Washers Fountain property Degreasers ❑ Autoclave/Sterilizers ❑ Cooling Towers ❑ Other- WASTEWATER DISCHARGE 1. Does the plumbing system currently have a grease interceptor? ❑ Yes ❑ No ❑ Don't Know Date grease trap/interceptor was last cleaned (provide service record): _ 2. Does the plumbing system currently have an oil/water separator? ❑ Yes ❑ No ❑ Don't Know 3. Date oil/water separator was last cleaned (provide service record): 4. Is water used in the business process(washing, rinsing,cooling)? ❑ Yes ❑ No ❑ Don't Know 5. Does your business require a NPDES permit? ❑ Yes ❑ No ❑ Don't Know 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 in accordaarA-m ille laws Liles nd regulation of the State of Waashington..^/ � pplicants Si nature Date r . i FF/TT� Print Applicants Name FOR STAFF USE ONLY Permit# Accepted By Amount Received Receipt# Date Received 6/16LP Page 3 of 3 i 11/2/2017 J&J HOME IMPROVEMENTS :Search L&I 3pF:ty 8,Health Claims&Insurance 'Plorkplace Rights Trades &Licensing Aft Washington State Department of kjLabor & Industries J & J HOME IMPROVEMENTS Owner or tradesperson 29623-3RD AVE NE PROFFITT,JIM J STANWOOD,WA 98292 360-629-2849 Principals SNOHOMISH County PROFFITT,JIM J,OWNER WA UBI No. Business type 601 104 502 Individual License Verify the contractor's active registration/license/certification(depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. JJHOMI*171DQ Effective—expiration 03/18/1983—11/14/2017 Bond CBIC $12,000.00 Bond account no. 617655 Received by L&I Effective date 09/11/2001 11/12/2001 Expiration date Until Canceled Insurance Contractors Bonding&Insuranc $1,000,000.00 Policy no. C11617655 Received by L&I Effective date 10/30/2017 11/12/2017 Expiration date 11/12/2018 Contractors Bonding&Insuranc $1,000,000.00 Policy no. C11617655 Received by L&I Effective date 09/19/2016 11/12/2015 Expiration date 11/12/2017 Insurance history iaita us irnprtave https://secure.Ini.wa.gov/verify/Detaii.aspx?UBI=601104502&LIC=JJHOMI*171 DQ&SAW= 1/2 11/2/2017 J&J HOME IMPROVEMENTS Savings No savings accounts during the previou,- year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period,but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. Workers' comp No active workers'comp accounts during the previous 6 year period. Public Works Strikes and Debarments Verify the contractor is eligible to perform work on public works projects. Contractor Strikes No strikes have been issued against this contractor. Contractors not allowed to bid No debarments have been issued against this contractor. Workplace safety and health No inspections during the previous 6 year period. Washington State Dept.or Labor&Industries.Use of this site is subject to the laws of the slate of Washington. https://secure.Ini.wa.gov/verify/Detail.aspx?UBI=601104502&LIC=JJHOMI"171 DQ&SAW= 2/2 Received OCT 2 6 2017 Ei71 O I — —' I� Pe 1 ;—F r 2)t 4 tS 11'4" TD CIO i H E�A M ld& IN AN, po tour T -71 CITY OF ARLINGTON BUILDING DEPARTMENT D � DATE-Z�ZI-Z BY NO CHANGES ALMHORIZED DO D UNLESS APPROM BY THE BUILDING INSPECTOR K D 41 - m D 3c WTI Permit#: 1714 Permit Date: 10/26/17 Permit Type: COMMERCIAL ALTERATION Project Name: Proffitt Applicant Name: Jim Proffitt Applicant Address: 29623 3rd Avenue NE Applicant, City, State, Zip: Stanwood, WA 98292 Contact: Jim Proffitt Phone: 206-295-9292 Email:jimproffitt@gmail.com Scope of Work: Remodel to walls plumbing and mechanical Valuation: 15000.00 Square Feet: 0 Number of Stories: 1 Construction Type: Occupancy Group: ID Code: Permit Issued: 11/02/2017 Permit Expires: Form Permit Type: Status: LASERFICHE Assigned To: Launa Black Property Parcel# Address Legal Description Owner Name Owner Phone Zoning portion of 116 E Fifth Street Widmark Family 00529900800102 Trust Contractors Contractor Primary Contact Phone Address Contractor Type License License# 29623 Third Ave CONSTRUCTION Labor d Jim Proffitt Jim Proffitt 206-295-9292 NE CONTRACTOR Isdustri anes JJHOMI*171DQ Inspections Date Inspection Type Description Scheduled Date Completed Date Inspector Status 11/07/2017 C20.BUILDING Approved FINAL Fees Fee Description Notes Amount Building Permit Table 4-1 $354.68 Building Plan Review Table 4-2 $230.54 Processing/Technology $25.00 State Surcharge- 1 st DU Residential- 1 st Unit $4.50 Total $614.72 Attached Letters Date Letter Description 11/02/2017 Building Permit Payments Date Paid By Description Payment Type Accepted By Amount 11/02/2017 Jim Proffit 67137422 cc $614.72 Outstanding Balance $0.00 Notes Date Note Created By: 10/26/2017 Adding 2 sinks,dishwasher and cooler. Launa Black Uploaded Files Date File Name 11/02/2017 2751494-1714 Issued Permit.pdf 10/26/2017 2732947-1714 Application.pdf