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HomeMy WebLinkAbout19209 CROWN RIDGE BLVD_BLD1778_2026 RESIDENTIAL PLUMBING PERMIT APPLICATION ING�� Department of Community & Economic Development City of Arlington• 18204 59th Ave NE • Arlington, WA 98223 • Phone (360) 403-3551 THIS APPLICATION IS TO BE USED WHEN APPLYING FOR NEW PLUMBING INSTALLATION FOR EXISTING RESIDENCES. PLEASE FILL OUT ALL PAGES OF THIS APPLICATION AND INCLUDE ALL INFORMATION. Project Address. 19209 crown ridge blvd Project Description:replace 50gal nat. gas water heater with new Owner: Marilyn Johnson 19209 crown ridge blvd Address: City:arlington State,wa Zip Code: 98223 Phone: 4254227173 Email: na Applicant:Jason Gay Address- 18821 11th ave ne City:arlington State wa Zip Code: 98223 Phone: 4254189545 Email: nwbathworks@gmail.com CONTRACTOR INFORMATION Contractor Name:nwbathworks Address: 18821 11th ave ne Citprlington StateWa Zip Code:98223 License Number:nwbatbl855pa Expiration may 2018 Phone-4254189545 Email.nwbathworks@gmail.com STAFF USE ONLY Permit #: Accepted by: Date REV 2015 Page 1 of 2 RESIDENTIAL PLUMBING PERMIT APPLICATION ING�� Department of Community & Economic Development City of Arlington• 18204 59th Ave NE • Arlington, WA 98223 • Phone (360) 403-3551 Plumbing Section (check all that apply) (Check all that apply and indicate the number of fixtures proposed) ❑ Bath/Shower Combo (4.0) x ❑ Sink (1.5) x ❑ Shower (2.0) x ❑ Lavatory (1 .0) x ❑ Clothes Washer (4.0) x ❑ Water Closet (2.5) x ❑ Dishwasher (1 .5) x Q Water Heater x 1 ❑ Hose Bibb (2.5) x Water Heater Model # ❑ Other (list) x g6-t4034nv Proposed Water Piping Size: 3/4_ Proposed Piping Material: copper Proposed DWV Material: abs Proposed DWV Size:tin • All hose bibs required to be equipped with Atmospheric Vacuum Breakers per ASSE 1019 • All water supplies at 80psi or greater shall have Pressure Reducing Valves (PRV) • Cross-Connection-Control may be required Applicant Signature: F_jaaacgay� Date: 12/12/2017 1 hereby certify that the above information is correct and that the construction, installation for the above mentioned property will be in accordance with the applicable laws of the City of Arlington and the State of Washington. REV 2015 Page 2 of 2 CITY OF ARLINGTON 238 N. OLYMPIC AVE-ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:19209 Crown Ridge Blvd Permit#:1778 Parcel#:00898100001800 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:JOHNSON MARILYN E Name:NW Bathworks,LLC Name:NW Bathworks,LLC Address: 19209 CROWN RIDGE BLVD Address:18821 1 lth Ave NE Address: 18821 1 lth Ave NE City,State Zip:ARLINGTON,WA 98223-4009 City,State Zip:Arlington,WA 98223 City,State Zip:Arlington,WA 98223 Phone: Phone:425-418-9545 Phone:425-248-0950 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name:NW Bathworks,LLC Address: Address: 18821 11th Ave NE City,State,Zip: City,State,Zip:Arlington,WA 98223 Phone: Phone:425-248-0950 LIC#: EXP: LIC#:BKS58307450 EXP:09/28/2017 JOB DESCRIPTION PERMIT TYPE: Residential Plumbing CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: 1 OCC GROUP: BUILDINGS: OCC LOAD: PERMIT APPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY;NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBC110/IRC110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of Arl' gt st e rt on your sales tax return form and c City o Arl'n on 101. S jnature Print Na a Date C//V WIMSellAy Date CONDITIONS Approved as submitted.Adhere to the installation of G6-T403NV. THIS PERMIT AUTHORIZS ONLY THE WORK NOTED,THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION. PERMIT FEES Date Description Fee Amount 12/14/2017 Plumbing Permit Base Fee $25.00 12/14/2017 Processing/Technology Fee $25.00 12/14/2017 Water Heater $25.00 Total Due: $75.00 Total Payment: $0.00 Balance Due: $75.00 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 qW PHONE; (360) 403-3551 BUILDING PERMIT Address:19209 Crown Ridge Blvd Permit#:1778 Parcel#:00898100001800 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:JOHNSON MARILYN E Name:NW Bathworks,LLC Name:NW Bathworks,LLC Address: 19209 CROWN RIDGE BLVD Address:18821 1 lth Ave NE Address: 18821 1 lth Ave NE City,State Zip:ARLINGTON,WA 98223-4009 City,State Zip:Arlington,WA 98223 City,State Zip:Arlington,WA 98223 Phone: Phone:425-418-9545 Phone:425-248-0950 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name:NW Bathworks,LLC Address: Address: 18821 11 th Ave NE City,State,Zip: City,State,Zip:Arlington,WA 98223 Phone: Phone:425-248-0950 LIC#: EXP: LIC#:BKS58307450 EXP:09/28/2017 JOB DESCRIPTION PERMIT TYPE: Residential Plumbing CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: 1 OCC GROUP: BUILDINGS: OCC LOAD: PERMIT APPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY;NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBC1101IRC110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of 7At%7:�12,3+7M ales tax return form and coded City of Arlington#3101. Signature Print Name Date I y Date CONDITIONS Approved as submitted. Adhere to the installation of G6-T403NV. THIS PERMIT AUTHORIZS ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION. PERMIT FEES Date Description Fee Amount 12/14/2017 Plumbing Permit Base Fee $25.00 12/14/2017 Processing/Technology Fee $25.00 12/14/2017 Water Heater $25.00 Total Due: $75.00 Total Payment: $0.00 Balance Due: $75.00 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 Community and Economic Development , Building Division INSPECTION RECORD SHALL REMAIN AT JOB Building construction shall not commence until permit SITE holder or agent has posted this Inspection Record Card in a conspicuous place on the premises. OWNER: Marilyn Johnson CONTRACTOR: NW Bathworks, LLC JOB ADDRESS:19209 Crown Ridge Blvd OWNERADDRESS: 19209 Crown Ridge Blvd USE of BUILDING: SFR PLAT NAME: Description of Work: New Gas HWT LOT# PERMIT NO: 1778 Sprinklered: CONDITIONS: See Permit DATE ISSUED: 12/14/2017 TYPE GROUP DEPARTMENT INSPECTION DATE DATE PASS FAIL INITIALS FOOTING BUILDING FOUNDATION INSPECTION LINE UNDERFLOOR (360)403-3417 SHEARWALL PLUMBING (groundwork) GAS PIPING(groundwork) ROUGH PLUMBING ROUGH GAS PIPING ROUGH HEATING&VENTILATION FRAMING INSULATION WALLBOARD(SHEAR/RATING) ROOF DRAINAGE DEVELOPMENT STORM INFILTRATION SERVICES GRADING INSPECTION LINE CURB GUTTER&SIDEWALK (360)403-3417 LANDSCAPE DRIVEWAY UTILITIES SIDE SEWER INSPECTION LINE SEWER CLEANOUT/FINAL (360)403-3508 WATER SERVICE INSPECTION WATER SERVICE FINAL CROSS CONNECTION FINAL (360)403-3417 FINAL INSPECTION All sections must be signed off prior to final inspection Electrical must be signed off prior to final inspection COMMENTS: CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:19209 Crown Ridge Blvd Permit#:1778 Parcel#:00898100001800 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:JOHNSON MARILYN E Name:NW Bathworks,LLC Name:NW Bathworks,LLC Address: 19209 CROWN RIDGE BLVD Address:18821 1 lth Ave NE Address: 18821 11th Ave NE City,State Zip:ARLINGTON,WA 98223-4009 City,State Zip:Arlington,WA 98223 City,State Zip:Arlington,WA 98223 Phone: Phone:425-418-9545 Phone:425-248-0950 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name:NW Bathworks,LLC Address: Address: 18821 1 lth Ave NE City,State,Zip: City,State,Zip:Arlington,WA 98223 Phone: Phone:425-248-0950 LIC#: EXP: LIC#:BKS58307450 EXP:09/28/2017 JOB DESCRIPTION PERMIT TYPE: Residential Plumbing CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: 1 OCC GROUP: BUILDINGS: OCC LOAD: PERMIT APPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY;NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBC110/IRC110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City ofArl• gt st a rt on your sales tax return form and c City o ArI n on 7.101_ r L —a �1�i. S nature Print Nafhe Date W1WSAAy Date CONDITIONS Approved as submitted. Adhere to the installation of G6-T403NV. THIS PERMIT AUTHORIZS ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION. PERMIT FEES Date Description Fee Amount 12/14/2017 Plumbing Permit Base Fee $25.00 12/14/2017 Processing/Technology Fee $25.00 12/14/2017 Water Heater $25.00 Total Due: $75.00 Total Payment: $0.00 Balance Due: $75.00 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 . � : e . , . , Permit Information Date 12/14/2017 Permit Number 1778 Project Name Johnson Applicant Name NW Bathworks,LLC Applicant Address 18821 11th Ave NE City,State,Zip Arlington,WA 98223 Contact Jason Gay Phone 425-418-9545 Email nwbathworks@gmail.com Permit Type Residential Plumbing Site Address 19209 Crown Ridge Blvd Valuation 0.00 Status Ready to Issue Permit Issued Permit Expires Square Feet 0 Type of Construction/Occupancy Load Number of Stories 0 Proposed Use Replace Gas HWT Assigned To Kristin Foster Property Owner Parcel Address Legal Owner Phone Zoning 00898100001800 19209 CROWN RIDGE JOHNSON MARILYN 111 Single Family Residence- BLVD E Detached Contractors Contractor Name Primary Contact Phone Email Contractor Type License License# INW Bathworks.LLC Jason Gay 425-248-0950 nwbathworks mail.com CONTRACTOR (Labor and Industries INWBATBL855PA Fees Fee Description Notes Amount Plumbing Permit Base Fee 322.10.00.00 $25.0 Processing/Technology Fee 341.43.00.02 $25.0 Water Heater 322.10.00.00 Total $75.0 Uploaded Files I Upload File Date I File I Uploaded B 12/14/2017 3:03:31 PM 11778 ADolication.odf I Foster, Kristin ?( RESIDENTIAL PLUMBING o e PERMIT APPLICATION IINGi Department of Community & Economic Development City of Arlington• 18204 59th Ave NE •Arlington,WA 98223• Phone(360) 403-3551 THIS APPLICATION IS TO BE USED WHEN APPLYING FOR NEW PLUMBING INSTALLATION FOR EXISTING RESIDENCES. PLEASE FILL OUT ALL PAGES OF THIS APPLICATION AND INCLUDE ALL INFORMATION. Project Address:19209 crown ridge blvd Project Description:replace 50gal nat. gas water heater with new owner: Marilyn Johnson Address:19209 crown ridge blvd Cit arlin ton y: 9 Stater Zip Code: 98223 Phone: 4254227173 Email: na Applicant:Jason Gay Address:18821 11th ave ne City:arlington Stater Zip Code: 98223 Phone: 4254189545 Email: nwbathworks@gmail.com CONTRACTOR INFORMATION Contractor Name:nwbathworks Address:18821 11th ave ne Cityarlington State!^ra Zip Code:98223 License Number:nwbatbl855pa Expiration:may 2018 Phone:4254189545 Email:nwbathworks@gmail.com STAFF USE O J Received Permit#: 16 Accepted by: Date [)EC 13 2017 REV 2015 Page 1 of 2 j`'Y °�' RESIDENTIAL PLUMBING PERMIT APPLICATION ! Department of Community & Economic Development City of Arlington• 18204 59th Ave NE •Arlington,WA 98223• Phone(360) 403-3551 Plumbing Section (check all that apply) (Check all that apply and indicate the number of fixtures proposed) ❑ Bath/Shower Combo (4.0) x ❑ Sink (1.5) x ❑ Shower (2.0) x ❑ Lavatory (1.0) x ❑ Clothes Washer (4.0) x ❑ Water Closet (2.5) x �1 Dishwasher (1.5) x Water Heater x 1 ❑ Hose Bibb (2.5) x Water Heater Model# Other (list) x g6-t4034nv Proposed Water Piping Size:3/4_^ Proposed Piping Material: copper Proposed DWV Material:ahs Proposed DWV Size: tin • All hose bibs required to be equipped with Atmospheric Vacuum Breakers per ASSE 1019 • All water supplies at 80psi or greater shall have Pressure Reducing Valves (PRV) • Cross-Connection-Control may be required Applicant Signature: ���A..-..• Date: 12/12/2017 1 hereby certify that the above information is correct and that the construction, installation for-,the above mentioned property will be in accordance with the applicable laws of the City of Arlington and the State of Washingtoh. REV 2015 Page 2 of 2 12/14/2017 NW BATHWORKS LLC (Search L&I /(.r<jJ1%3 i,f7� iii1Jili i ''::l to CS< I i If?E� Washington State Department of " Labor & Industries NW BATHWORKS LLC Owner or tradesperson 18821 11TH AVE NE Principals ARLINGTON,WA 98223 425-418-9545 GAY,JASON BRIAN,PARTNER/MEMBER SNOHOMISH County BESANCON,GREGORY THOMAS,PARTNER/MEMBER BESANCON,BRENT ALLEN,MANAGER Doing business as NW BATHWORKS LLC WA UBI No. Business type 603 537 470 Limited Liability Company Governing persons BRENT A BESANCON GREG BESANCON; JASON BRIAN GAY; 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. NWBATBL855PA Effective—expiration 10/01/2015-10/01/2019 Bond Ironshore Indemnity Inc $12,000.00 Bond account no. SUR40015865 Received by L&I Effective date 09/28/2017 09128/2017 Expiration date Until Canceled Bond history Insurance Ohio Security Ins Co $1,000,000.00 Policy no. BKS58307450 Received by L&I Effective date 09/28/2017 09/28/2017 Expiration date 09/28/2018 https://secure.Ini.wa.gov/verify/Detail.aspx?UBI=603537470&LIC=NWBATBL855PA&SAW= 1/2 12/14/2017 NW BATHWORKS LLC Ohio Security Ins Co $1,000,000.00 Policy no. BKS56910784 Received by L&I Effective date O8/28/2017 09/28/2015 Expiration date 09/28/2018 Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L8d Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period,but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. Workers' comp Do you know if the business has employees?If so,verify the business is up-to-date on workers'comp premiums. L&I Account ID Account is current. 285,684.01 Doing business as NW BATHWORKS LLC Estimated workers reported Quarter 3 of Year 2017"Less than 1 Workers" L&I account contact T2/LINDA ALGUIRE(3601902-4678-Email:POTH235(cDIni.wa.gov 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. lAlashington Stato Dirt.of Lahor B,Industries.Aw of this site is subject to tho laws of tho stato of Washington, https://secure.Ini.wa.gov/verify/Detail.aspx?UBI=603537470&LIC=NWBATBL855PA&SAW= 2/2 BUILDING INSPECTION REPORT — PLUMBING (HWT) Permit No 1778 Address: 19209 Crown Ridge Blvd Contractor: NW Bathworks, LLC Owner: JOHNSON MARILYN E Date: 1/12/2018 ® APPROVAL ❑ PARTIAL APPROVAL ❑ CORRECTION ❑ OTHER APPLIANCE: GAS HWT LOCATION OK: © L&I: ❑ EXPANSION TANK: ® SEISMIC: INSULATION: ® VENTING (6x6 collar): 18 INCHES OR FVIR: ® PRV 6 INCHES: SHUT-OFF VALVE: © PRV < 150PSI: DRAIN: © DRIP LEG: IMPACT PROTECTION: ® ACCESS: COMBUSTION AIR: Date: 1/12/2018 Inspector: Kevin Olander Permit#: 1778 Permit Date: 12/14/17 Permit Type: RESIDENTIAL PLUMBING Project Name: Johnson Applicant Name: NW Bathworks, LLC Applicant Address: 18821 1 Ith Ave NE Applicant, City, State, Zip: Arlington,WA 98223 Contact: Jason Gay Phone: 425-418-9545 Email: nwbathworks@gmail.com Scope of Work: Replace Gas HWT Valuation: 0.00 Square Feet: 0 Number of Stories: 0 Construction Type: Occupancy Group: ID Code: Permit Issued: 0l/11/2018 Permit Expires: Form Permit Type: Status: COMPLETE Assigned To: Kristin Foster Property Parcel# Address Legal Description Owner Name Owner Phone Zoning 00898100001800 19209 CROWN RIDGE JOHNSON 111 Single Family BLVD MARILYN E Residence-Detached Contractors Contractor Primary Contact Phone Address Contractor Type License License# NW Bathworks,LLC Jason Gay 425-248-0950 18821 1 lth Ave CONSTRUCTION Labor andNWBATBL855PA NE CONTRACTOR Industries Inspections Date Inspection Type Description Scheduled Date Completed Date Inspector Status 01/12/2018 R00.WATER 01/12/2018 BUILDING Completed HEATER FINAL Fees Fee Description Notes Amount Plumbing Base Permit Fee $25.00 Processing/Technology $25.00 Water Heater(Tank) $25.00 Total $75.00 Attached Letters Date Letter Description 12/14/2017 Building Permit Payments Date Paid By Description Payment Type Accepted By Amount 12/18/2017 jason gay 67727812 cc $75.00 Outstanding Balance $0.00 Notes Date Note Created By: 12/18/2017 Emailed permit for signature.KF Kristin Foster Uploaded Files Date File Name O1/12/2018 2949094-19209 Crown Ridge Blvd.docx O1/11/2018 2945556-1778 Issued Permit.pdf 12/14/2017 2856669-1778 Application.pdf