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HomeMy WebLinkAbout103 N DUNHAM AVE_BLD1785_2026 RESIDENTIAL MECHANICAL PERMIT APPLICATION t�N 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 MECHANICAL INSTALLATION AND OR GAS PIPING FOR EXISTING RESIDENCES. PLEASE FILL OUT ALL PAGES OF THIS APPLICATION AND INCLUDE ALL INFORMATION. Project Address- 103 N Dunham Project Description-install ductless heat pump Owner: Iris Forbus Ingram Address. 103 N Dunham City. Arlington State.WA Zip Code: 98223 Phone. 425-343-6961 Email:nordstromha@comcast.net Applicant: Nordstrom Heating & Air Address: 4717 87th Ave NE City. Marysville State.WA Zip Code: 98270 Phone. 425-335-4029 Email. nordstromha@comcast.net CONTRACTOR INFORMATION Contractor Name:Nordstrom Heating & Air Address: 4717 87th Ave NE City: Marysville State.WA Zip Code: 98270 License Number. nordsha884jw Expiration: 03/30/2017 Phone: 425-335-4029 Email:nordstromha@comcast.net STAFF USE ONLY Permit #: Accepted by: Date: 6/16LP Page 1 of 2 Y. RESIDENTIAL MECHANICAL PERMIT APPLICATION SING Department of Community& Economic Development City of Arlington • 18204 59th Ave NE• Arlington, WA 98223• Phone(360) 403-3551 SELECT ALL PROPOSED APPLIANCES ❑ Furnace (80+) Model # AFUE Heat Pump Model #msz-gll8na AFUE HSPE11.2 ❑ AC Unit Model # SEER ❑ Freestanding Stove ❑ Fire Place Insert ❑ Outdoor BBQ ❑ Gas Piping ❑ Solid-Fuel Appliance ❑ Other Gas Piping Information Not Applicable: ❑ Pipe Material: Pipe Size: Distance from Meter to Furthest Appliance: Total BTU's of all Appliances: • New gas piping requires a pressure test hooking to any appliance • Sediment traps (drips) are required on all gas lines • Gas lines are required to be supported/secured every 6 to 8 feet • Proper Combustion air and venting required for all appliances • A shut-off valve is required within 6 feet of all appliances Liz) � Applicant Signature: d5i513be"a92O e" Date: 12/20/2017 Applicant Printed Name: Debbie Elgin I 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. 6/16LP Page 2 of 2 CITY OF ARLINGTON 238 N. OI.YMPIC AVF. -.ARLINUIDN. A'A. 99223 PITONS; (360)401-3551 BUILDING PERMIT _ Odd v-".-103 N nuaha.Ave Terautt+:i-" — Parcel Y:30370I(Wi I vw ValwicM 0.00 OWNER AYFLIC'ANT CONTRACTOR Nanw:114AAM WS Nwnc-�kedsuum Ikaling S Air,Inc Nww:NQ XtOS R(Al HF.ATIN(i X-Alit LW Addrm:21401E VIRGINIA AVE AAdre.<47)7$h),AwISE Address:3914 Mh Saver V k City.St-w.ZiF:F_WWW,WA 9R2111 City.Soft Zip-Nitoylvilic,WA 9977a ric.,silk zip:ns.4xYsvti_z.w•A 99M Phone- Pbone:425-335-.ar--Y Pt ,,ne 47s-ViS4CN MECHANICAL CONTRACTOR PT T-MBM CONTRACTOR Nona `(1KIWIA iM KEATM(i X•AIR INC ame: Address;:393)M Scrm Ni,. AJJrcna. City.Sate.Lip'MARYSMI I.E.WA 9U270 City.Sane,Zip: KOM:4:1—C3%-fOL)9 - LIC*:NOPMEW941W [!XP 04 Ity2D12 t.il'a EX?. JOB DESCRTMON PFK?61JvTYPE` Residential Mechanical CODE YEAR- 2015 STORM& MNST.TOTE: flwTLLINci t1Nn-s: 1 (xt-0R(1I!r R-3 BULDINOS t1LL LOAD: PERNUT APPROVAL I AijUE TO WW'LY W:TIE CITY AND STATL LAwS RLGUL\TrtiG CCWSTRUCTION AND iN WAWi 111F.WORK AtrI*H<KII%FI) THEREBY:NO['LRSON N%7LL DE LLlM YT-M IN V ICX.ATIt7N OF THE LANOR C't 11?F(1t: IIiF s'rA rv.(v W ASHI%IUT QN RELATING TO WORKMEWS COMMNSAWN IX.q-RAWCr.ANT)RCIk 11.27 TIUS APPIJC-AMN I.S.NOT A PFR!uIT SIONED RY THE HUILMS00EF ML OR EEIS�IEER DCrLrTY:tND ALL FEES ARF.PALE) rr IS UNI.AWKII.TO ILSE OR UCCUPY A BUILDING OR STRCC .-RE INTIL A FINAL INSPFCTICN ti arr..N AiAt71:AND APPROVAL OR A CERTIFICATE•Ot'OCCLT.INCY I L•tS DCL,GR,INTLLI. IIIC I It.1?RC.t 10. SALES r.%x NCYrK't:lmies ra relatng to.^n11RfILLT.va nt►!a> 1ntG1Mn mil:rtAls c the Cit.ofAriin�fon our saks=.x rmrn fi" aa1 fh4d 01 of Arboulun 0 -Ly-ilbm I t-� -- I Si�nalurr Print tiara: Dab cz DINT CONIDMONS Approved as submitted,Additional requirements: 3" concrete pad with seismic bracing attachod to lmd, provide electrical disconnect, line~shall he insulatcd -the use of adhesive tape is not perniitted. Itli)?"uIAVl1A(-*1aLv-�lYTiiLWL*.K,%UILU.'I HIS AWAIT LOVI-RSWL*tKTOBlFIXX%�(1riPRIVAT}PRt7P1=ATYMIN ANY LC)NSIRCy--TION ON THE PI rRl3r 1XIMA1N(MILKS,SMFWAI XS.-'WW WAYS,MARQt FFC.FTC.)WILL RL'QIJIRL SITARA R:PLKmiss N PERN T FEES Dale�� — -- Descriptnon Fee Atnturt 1221rr07 Fleet Putrlp $25.00 121 tW`17 r ad anor Pwme,Ease=ee S215 00 1221j2D17 Prccessing.Technoiogy Fee $25.00 Total Due: V-91 O Total Nvmcnt Balaoce Dae 575.110 CALL FOR INSPECTIONS stuDiNc 13441403-3411 W ben 02114ng for to inspth Gan p cxjc.Ifave low fwkMist iulur:nrchrt,: Permit Vrtulxi.T�pr ofImpr(sion brinC reVwerled,atW wheber+w prefer mereirtt or efternuos A S-4A CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON,WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:103 N Dunham Ave Permit#:1785 Parcel#:00378800401100 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:INGRAM IRIS Name:Nordstrom Heating&Air,Inc. Name:NORDSTROM HEATING&AIR INC Address:2002 VIRGINIA AVE Address:4717 87th Ave NE Address:3930 88th Street NE City,State Zip:EVERETT,WA 98201 City,State Zip:Marysville,WA 98270 City,State Zip:MARYSVILLE,WA 98270 Phone: Phone:425-335-4029 Phone:425-3354029 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name:NORDSTROM HEATING&AIR INC Name: Address:3930 88th Street NE Address: City,State,Zip:MARYSVILLE,WA 98270 City,State,Zip: Phone:425-335-4029 Phone: LIC#:NORDSHA884JW EXP: 04/16/2012 LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Residential Mechanical CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: 1 OCC GROUP: R-3 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 S BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBC 110/IRC 110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of Arlin on po d o our sales tax return form and coded City of Arlington#3101. Z• .Z011 Signature Print Name Date lea y Date CONDITIONS Approved as submitted.Additional requirements: 3" concrete pad with seismic bracing attached to pad, provide electrical disconnect, lines shall be insulated-the use of adhesive tape is not permitted. THIS PERMIT AUT 40RIZS 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 12/21/2017 Heat Pump $25.00 12/21/2017 Mechanical Permit Base Fee $25.00 12/21/2017 Processing/Technology Fee $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: Iris Ingram CONTRACTOR: Nordstrom Heating and Air, Inc. JOB ADDRESS:103 N Dunham Ave OWNERADDRESS: 103 N Dunham Ave USE of BUILDING: SFR PLAT NAME: VB R3 Description of Work: Install Ductless Heat Pump LOT# PERMIT NO: 1785 Sprinklered: CONDITIONS: See Permit DATE ISSUED: 12/21/2017 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: DATA. tit STUIH WALL-MOUNTED HEAT PUMP SYSTEM AM,ELECTRIC Job Name: System Reference: Date: 208/230V, 1-Phase, 60 Hz M- " Ci Minimum rcuitAmpacity(MCA) Indoor Unit:MSZ-GL18NA-U1 e Indoor/Outdoor A 1 /14 Wireless Remote Controller Outdoor Unit:MUZ-GLI8NA-U1 ACCESSORIES: Blower Motor(ECM) F.L.A. 0.67 Indoor Unit Blower Motor Output w 30 ❑ Condensate Pump(BlueDiamond X87-711/721;115/230V) ❑ Condensate Pump(Sauermann S130-115/230;115/230V) SHF/Moisture Removal 0.87/2.1 pt./h ❑ Anti-Allergy Enzyme Filter(MAC-408FT-E) ❑ Drain Pan Level Sensor(DPLS2) Field Drainpipe Size O.D. In.(mm) 518(15) Outdoor Unit Outdoor ❑ Outdoor Mounting Pad(ULTRILITEi) Compressor DC INVERTER-driven Twin Rotary ❑ Drain Pan Heater(MAC-642BH-U) ❑ 3-1/4"Mounting Base[Pair](DSD-400P) Fan Motor(ECM) F.L.A. 0-93 ❑ Drain Pan Socket(MAC-851 DS) ❑ Air Outlet Guide(MAC-886SG-E) Quiet ❑ Wall Mounting Bracket(QSWB2000M-1) Indoor DRY 259-333-416-523-646 Controls (Cooling) WET 233-300-375-470-581 ❑ Wireless Controller(MHK1) ❑ Wired Remote Controller PAR-32MAA(Requires MAC-3331F-E) Indoor cFM DRY 296-384 469-563-646 ❑ Wireless Interface for kumo cloudT""(PAC-USWHS002-WF-1) (Heating) ❑ Thermostat Interface(PAC-US444CN-1) Outdoor 1,691 /1,691 SPECIFICATIONS: —- ---------- Sound <. -. Ht Rated Conditions(Capacity/inpu6 Cooling 28-33-38-44-49 Cooling' BtuthtW 18,000/1,340 Indoor Heating 2$-33-38-43-48 Heating at 47°Fz Btuth/w 21,600/1,680 dB(A) Cooling 54 Outdoor S' $® Heating 55 Cooling' Btulh 5,800 22,000 Dimension Heating at 470 Fz Btu/h 5,400 25,000 0 3 Indoor(H x W x D) 12 x 36-5/16 x 9-13116 Heating at 17 F Btulh - 18,200 (305 x 923 x 250) Heating at 5°F4 Btulh - 14,500 In.(mm) 34-5/8 x 33-1/16 x 13 'Cooling 1 Indoor:800 F(27°C)DB/670 F(19°C)WB;Outdoor.950 F(35°C)DB/75,F(24°C)WB` Outdoor(H x W x D) (880 x 840 x 330) Heating at 47°F I Indoor:70'F(21°C)DB 160'F(16"C)WB;Outdoor.47'F(8°C)DB 1431 F(6°C)WB' 'Heating at 17'F I Indoor:701 F(21"C)DB/60'F(16'C)WB;Outdoor:171 F(-8°C)DB 1151 F(-9°C)WB' 4 Heating at 5°F I Indoor:700 F(210 C)DB 160°F(16°C)WB;Outdoor:5°F(-15°C)DB 150 F(-15°C)WI37'nudoor .Rating Conditions perAHRI Standard: 28(13) Lbs.(kg)••- . • •a• 121 (55) Cooling2s 90°F(32°C)DB/67°F(19°C)DBExternal Finish Heating 80°F(27°C)DB/70°F(21°C)DB -- - -- Indoor Munsell 1.OY 9.2 10.2 •` • Con.ditons,(OutdoorOutdoor Munsell No.3Y 7.$!1.1 Cooling5 115 F(46°C)DB/14°F(-10°C)DB - •- . R410A;3 Ib.9 oz. Heating 75°F(24°C)DB/-4°F(-20°C)DB" s Applications should be restricted to comfort cooling only;equipment cooling applications are not Refrigerant Piping -° recommended for law ambient temperature conditions. - "'System cuts out at-91 F(-27°C)to avoid thermistor error and automatically restarts at-4°F(-20°C). Liquid(High Pressure) 1/4(6.35) fn.(mm) — Gas(Low Pressure) 1/2(12.7) AHRI Efficiency�Ratings SEER/HSPF 20.5/11.2 Max.Total Refrigerant 50(15) _ Pipe Length(Height Diff.) COP at 470.F 1170 F 3.77!2.73 Ft.(m) Max.Total Refrigerant 100(30) Yes Pipe Length(Length.) ENERGY STAR products are third-party certified by an EPA-recognized Certification Body. t5peancations are suo)eci io change wllnoui nonce. ©2016 Mitsubishi Electric US,Inc. e- E'n iq X j E3 '•; .sL .sL U. i 3 ao i w € rL = of b E O r r j a sue- 04 U 9 U E * E U a I y �.�81 � "1 , � Yv_.� Art--- .oL .sL s zo Z. s CITY OF ARLINGTON 239 N.OLYMPIC A'VF.-A-KJ-IN[;l'UN,WA,9821-3 PHONE.;(160)40.33-W 1 BUILDING PERMIT Aililtrw pvrnnit ft!17XS vjlu dan!rl"M ONVNER APPLICANT CONTRACTOR liante:1140CANI eRly, Nwnr--Nwdstrunn lkwing Lie, Nan w:',A N 1 1,V I W.Al H F.A�I N C i X All'1"Y,' A dd�- ;NWT2'V I YN i I N IA Av K AAlrsx 4717 R-70,Ave NIL AJdTrus:AM thh.Rnrves i I, CiLy.'.;U#,Zip:TNERTITT,1Al 9R211 I Ch.Scud 7.iP*,%iwyE,dk.WA 9H,'A CAy,5110k.ZiPMA611,S ]—E,WqL981J?,) phow, Pbm-.423-335-4AI9 FT"c:471-331-40N MECHANICAL CONTRACTOR PUTMMG CONTRACTOR Nwnrw NORITNTILQlA hMA-,[N(i.V,,A1R NC Name: is ay,Sr;w.Zip MARYwil I-U-WA 99270 City.SYeae.7-in: NOW 4,S-kl 40,9 LEC N:NORDSHAS&Ok 11,XT, 4W 1 tv,.,It 12 Ellp. JOB DESCRTMON JtCSj4dCntjaj MC4ChjnjCaj C Cl X VE A R 2015 S-MRITS: CWST,TYPE D%�TLLJW UNrl"S: 1 (WC.SMflrll- R-3 BUILDINGS UVU:LOe"Jr PERMIT APPROVAL I MIKEF*I*Q(X>W-Y WMtCj'rY ANDSIATL L,%W3 REGUL%MM,CONSIV CIMNAND IM WIFY. Alilwwwyo THEREBY.N0 VEMON)WLL 13E rMPIGYMN VER.AnON 09TH(,,f.ARCIR w ksmNuiy:,N RELATINC Wl-)RKMD S COMPrNSATInN KSURANCT AV)Rl,".W 13.17 TT S APPIACAT",UNIS,NO; It L4LqL:,lVJ0(•RCLkLC)R HI.&IMR DEMUTY--ND ALL FEDSAWli PAJO T 1S UNI AWFULTOUSE MC(DULIPY A13LLLDWG�-T,37TZrJl-M.R[UNTILA P'N.Al.INSPUTICA� c ISFS-4 VArW ANDAFVRC-jVA(,QP, ,kL-Z,'�-nECAT--OFOCCLP.,LXCYIL,3SDECXG,R,,e4TE.D. .,."t-v%;mvvyrtct.. raN ruen—AftI.OsAlliolion allumhkin dvv(7dj ktrArh i&m- - rtlatag M--D6 41ful, 71'Like Lrua Nainnu CONDITIONS Approvcd as submitted,:'Additionalrequirem-eats,3 co�tiere(L-�pad-with—qeisrriic bracing sttjcht�d to pad, provide rledrical discA3nncct,lines shall he insulawd-the use of adhesive tape Is not pumitted. 11154 JjlL,WcV.KsJlU)-j)4 RF PKAATFPRilrFR-rYCAA V ANY IZ Wffl?ZQUM 5[P.4J*.M,PUUAMIUN PERMIT FEES Description Foa Amount 122lW7 Heal Pump U15.00 12?21 QD17 V-90Qr*c-al Ps^rvlO Eiese tea W-00 122112217 Prctas;!:mGVTact,-iccqy Fe* 125.DO T001 Dtw, Vs-W Tatol payattelz CALL FOR INSPECTIONS &Llab[NG jj"I When"lWnfnr*h iaspaclon pi"w itAvr-qjL.,. Pfrwit Nmnah",7tj)twrlwp*.(4i*w be.4-ig requewed,and vkrtberpm Prdwnnwafor allernuut CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:103 N Dunham Ave Permit#:1785 Parcel#:00378800401100 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:INGRAM IRIS Name:Nordstrom Heating&Air,Inc. Name:NORDSTROM HEATING&AIR INC Address:2002 VIRGINIA AVE Address:4717 87th Ave NE Address:3930 88th Street NE City,State Zip:EVERETT,WA 98201 City,State Zip:Marysville,WA 98270 City,State Zip:MARYSVILLE,WA 98270 Phone: Phone:425-335-4029 Phone:425-335-4029 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name:NORDSTROM HEATING&AIR INC Name: Address:3930 88th Street NE Address: City,State,Zip:MARYSVILLE,WA 98270 City,State,Zip: Phone:425-335-4029 Phone: LIC#:NORDSHA884JW EXP: 04/16/2012 LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Residential Mechanical CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: 1 OCC GROUP: R-3 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 INSPECTIONKkS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBC1I0/IRC110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of Arlin on po 0 our sales tax return form and coded City of Arlington#3101. �2. •��� Signature Print Name Date WIC&Wy Date CONDITIONS Approved as submitted. Additional requirements: 3" concrete pad with seismic bracing attached to pad, provide electrical disconnect, lines shall be insulated -the use of adhesive tape is not permitted. 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 12/21/2017 Heat Pump $25.00 12/21/2017 Mechanical Permit Base Fee $25.00 12/21/2017 Processing/Technology Fee $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 12/21/2017 NORDSTROM HEATING&AIR INC (Search L&I Alft Washington State Department of `4 Labor & Industries NORDSTROM HEATING &AIR INC Owner or tradesperson 4717 87TH AVE NE MARYSVILLE,WA 98270 Principals 425-335-4029 NORDSTROM,DANIEL JASON,PRESIDENT SNOHOMISH County AHLERS&CRESSMAN PLLC,AGENT Doing business as NORDSTROM HEATING&AIR INC WA UBI No. Business type 602 279 145 Corporation 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. NORDSHAS84JW Effective—expiration 04/16/2012—04/16/2018 Bond Developers Surety&Indem Co $12,000.00 Bond account no. 256304C Received by L&I Effective date 04/16/2012 04/12/2012 Expiration date Until Canceled Insurance Federated Mutual Ins Co $1,000,000.00 Policy no. 9869472 Received by L&I Effective date 04/04/2017 05/07/2017 Expiration date 05/07/2018 Insurance history Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savinys 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. https://secure.Ini.wa.gov/verify/Detail.aspx?UBI=602279145&LIC=NORDSHA884JW&SAW= 1/2 12/21/2017 NORDSTROM HEATING&AIR INC License Violations No license violations during the previous ;ar 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. 099,363-00 Doing business as NORDSTROM HEATING&AIR INC Estimated workers reported Quarter 3 of Year 2017"4 to 6 Workers" L&I account contact T3/NATHAN KOZAK(360)902-6243-Email:KOZN235@lnl.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. ©Washington State Dept.of Labor&.Industries.Use of this site is subject to the laws of the state of Washington. https://secure.Ini.wa.gov/verify/Detail.aspx?UBI=602279145&LIC=NORDSHA884JW&SAW= 2/2 IV. RESIDENTIAL MECHANICAL PERMIT APPLICATION Department of Community& Economic Development City of Arlington • 18204 591h Ave NE• Arlington, WA 98223• Phone(360) 403-3551 THIS APPLICATION IS TO BE USED WHEN APPLYING FOR NEW MECHANICAL INSTALLATION AND OR GAS PIPING FOR EXISTING RESIDENCES. PLEASE FILL OUT ALL PAGES OF THIS APPLICATION AND INCLUDE ALL INFORMATION. Project Address:103 N Dunham Project Description:install ductless heat pump Owner: Iris Forbus Ingram Address: 103 N Dunham City:Arlington StateWA Zip Code: 98223 Phone: 425-343-6961 Email:nordstromha@comcast.net Applicant- Nordstrom Heating & Air Address:4717 87th Ave NE City: Marysville State WA Zip Code: 98270 Phone: 425-335-4029 Email: nordstromha@comcast.net CONTRACTOR INFORMATION Contractor Name:Nordstrom Heating & Air Address:4717 87th Ave NE City: Marysville State WA Zip Code: 98270 License Number:nordsha884jw Expiration: 03/30/2017 Phone:425-335-4029 Ernai1:nordstromha@comcast.net STAFF USE O LY Received Permit #: � 1' Accepted by 5� . Date: OEC 2 0 AP 6/16LP Page 1 of 2 RESIDENTIAL MECHANICAL w • 0 PERMIT APPLICATION �N Department of Community& Economic Development City of Arlington • 18204 59th Ave NE• Arlington, WA 98223• Phone(360)403-3551 SELECT ALL PROPOSED APPLIANCES ❑ Furnace (80+) Model # AFUE_ Q Heat Pump Model ##msz-g118na AFUE HSPE11.2 ❑ AC Unit Model # SEER ❑ Freestanding Stove ❑ Fire Place Insert ❑ Outdoor BBQ ❑ Gas Piping ❑ Solid-Fuel Appliance ❑ Other Gas Piping Information Not Applicable: ❑ Pipe Material: Pipe Size: Distance from Meter to Furthest Appliance: Total BTU's of all Appliances • New gas piping requires a pressure test hooking to any appliance • Sediment traps (drips) are required on all gas lines • Gas lines are required to be supported/secured every 6 to 8 feet • Proper Combustion air and venting required for all appliances • A shut-off valve is required within 6 feet of all appliances o�e�(ce C�'Cgu2 Applicant Signature: K... . �.....�..M,,. Date: 12/20/2017 Applicant Printed Name: Debbie Elgin hereby certify that the above information is correct and that the construction, installation for the aboye;mentioned property will be in accordance with the applicable laws of the City of Arlington and the State of Washington. 6/16LP Page 2 of 2 SUBMITTROATA: i 1 i s f 111WALL-MOUNTED Job Name: System Reference: Date: 208/230V, 1-Phase, 60 Hz Indoor Unit:MSZ-GL18NA-Ul Indoor/Outdoor A 1 /14 Wireless Remote Controller � �+•+ Outdoor Unit;MUZ-GLI8NA-Ul e ACCESSORIES: Blower Motor(ECM) F.L.A. 0.67 Indoor Unit ❑ Condensate Pump(BlueDiamond X87-7111721;115/230V) Blower Motor Output W 30 ❑ Condensate Pump(Sauermann S130-115/230;1151230V) SHF/Moisture Removal 0.87/2.1 pt./h Ei Anti-Allergy Enzyme Filter(MAC-408FT-E) Field Drainpipe Size O.D- In.(mm) 58 Li Drain Pan Level Sensor(DPLS2) 115( ) Outdoor Unit • Outdoor Mounting Pad(ULTRILITEI) Compressor DC INVERTER-driven Twin Rotary ❑ Drain Pan Heater(MAC-642BH-U) ❑ 3-1/4"Mounting Base[Pair](DSD-400P) Fan Motor(ECM) F.L.A. 0.93 ❑ Drain Pan Socket(MAC-851 DS) ❑ Air Outlet Guide(MAC-886SG-E) 71ndoor ❑ Wall Mounting Bracket(QSW62000M-1) ControlsY 259-333-416-523-646 T 233-300-375-470-581 ❑ Wireless Controller(MHK1) CFM Wired Remote Controller PAR-32MAA(Requires MAC-3331F-E) DRY 296-384-469-563 646 ❑ Wireless Interface for kumo cloud TM(PAC-USWHS002-WF-1) (Heating) ❑ Thermostat Interface(PAC-US444CN-1) Outdoor 1,691 11,691 SPECIFICATIONS: - - Sound L - L Cooling 28-33-38-44-49 Cooling Bluth iW 18,000 11,340 Indoor Heating 28-33-38-43-48 Heating at47°F1 Bluth lW 21,600/1,680 dB(A) Cooling 54 Outdoor - Heating 55 Cooling' Bluth 5,800 22,000 Heating at 470 Fz Bluth 5.400 25,000 Heatingat 170 F3 Btulh - 18,200 Indoor(H7WxD) 12 x 36-5/16 x 9-13/16 (305 x 923 x 250) Heating at 5°F4 Bluth 14,500 In.(mm) Outdoor(H x W x D) 34-5/8 x 33-1/16 x 13 Cooling I Indoor:80'F(27°C)DB 167°F(19°C)WB;Outdoor.95°F(35°C)DB 1 75°F(24°C)WB' (880 x 840 x 330) Heating at 47°F I Indoor:70'F(21°C)DB/60'F(16'C)WB;Outdoor-47°F(6°C)DB/43°F(6°C)WB- -- Heating at 17°F I Indoor.70°F(21°C)DB 160°F(16°C)WB;Outdoor:17"F(-8°C)DB/15°F(-9°C)WB' °Heating at 5°F I Indoor:70°F(21°C)DB/60°F(16°C)WB;Outdoor.5°F(-15°C)OB 15°F(-15°C)WB 71rtdoor' 'Rating Conditions perAHRI Standard: 28(13) •._ . Lhs.(ti91 121 (55) Cooling" 90°F(32°C)DB/67°F(19°C)DB MUNI Heating 80°F(27°C)DB/70°F(21°C)DB Indoor Munsell 1.0Y 9.2/0.2 • Outdoor Munsell No.3Y 7.8/1.1 7H..ti'ng� 115 F(46°C)DB/14°F(A0°C)DB R410A;3 Ib.9 oz. — — - - 75°F(24°C)DB!-4°F(-20°C)DB'" -'Applications should be restricted to comfort cooling only;equipment cooling applications are not recommended for low ambient temperature conditions. System cuts out at-9°F(-27°C)to avoid thermistor error and automatically restarts at-4°F(-20°C). Liquid(High Pressure) 1/4(6.35) In.(mm) Gas(Low Pressure) 1/2(12.7) 7COPat PF 20,5/11.2 Max.Total Refrigerant 50(15) Pipe Length(Height Diff.) F/17°F 3.77/2.73 Ft.(m) Max.Total Refrigerant 100(30) Yes Pipe Length(Length.) ENERGY STAR products are third-party certified by an EPA-recognized Certification Body. Speciucauons are suo)eci to cnange witnoui notice. C 2016 Mitsubishi Electric US,Inc. w} S io m e- r OL Oi 9L ,9 to >b I I BUILDING INSPECTION REPORT — MECHANICAL (RESIDENTIAL) Permit No. 1785 Address: 103 N Dunham Ave Contractor: Nordstrom Heating & Air, Inc. Owner: INGRAM IRIS Date: 1/30/2018 ® APPROVAL ❑ PARTIAL APPROVAL ❑ CORRECTION ❑ OTHER APPLIANCE: Ductless Heat Pump CO DETECTOR: © HEAT PUMP/AC UNIT: GAS PIPING: ❑ DISCONNECT: DRIP LEG: ❑ SEISMIC: VENTING: ❑ 3" PAD: ACCESS: ❑ INSULATION/PROTECTION: SHUT-OFF VALVE: ❑ DUCTS: N/A L&I: Yes Date: 1/30/2018 Inspector: Kevin Olander Permit#: 1785 Permit Date: 12/21/17 Permit Type: RESIDENTIAL MECHANICAL Project Name: Ingram Applicant Name: Nordstrom Heating &Air, Inc. Applicant Address: 4717 87th Ave NE Applicant, City, State, Zip: Marysville,WA 98270 Contact: Debbie Elgin Phone: 425-335-4029 Email: nordstromha@comcast.net Scope of Work: Install Ductless Heat Pump Valuation: 0.00 Square Feet: 0 Number of Stories: 0 Construction Type: Occupancy Group: ID Code: Permit Issued: 01/02/2018 Permit Expires: Form Permit Type: Status: COMPLETE Assigned To: Kristin Foster Property Parcel# Address Legal Description Owner Name Owner Phone Zoning 00378800401100 103 N DUNHAM AVE INGRAM IRIS 111 Single Family Residence-Detached Contractors Contractor Primary Contact Phone Address Contractor Type License License# NORDSTROM 1059 State Ave. CONSTRUCTION HEATING&AIR INC 425-335-4029 Ste.G CONTRACTOR COA 601764617 NORDSTROM 1059 State Ave. CONSTRUCTION Labor&NORDSHA772L2 HEATING&AIR INC 425-335-4029 Ste.G CONTRACTOR Industries Inspections Date Inspection Type Description Scheduled Date Completed Date Inspector Status O1/31/2018 R00.HEAT PUMP/ 01/30/2018 BUILDING Completed AC UNIT FINAL Fees Fee Description Notes Amount Heat Pump/Heat Exchangers $25.00 Mechanical Base Permit Fee $25.00 Processing/Technology $25.00 Total $75.00 Attached Letters Date Letter Description 12/21/2017 Building Permit Payments Date Paid By Description Payment Type Accepted By Amount 12/21/2017 DANIEL NORDSTROM 67765778 cc $75.00 Outstanding Balance $0.00 Notes Date Note Created By: 12/22/2017 Emailed permit for signature Launa Black Uploaded Files Date File Name O1/31/2018 3001599-103 N Dunham Ave.docx O1/02/2018 2917481-1785 Issued Permit.jpg 12/21/2017 2870967-1785 Specs and Site Plan.pdf 12/21/2017 2870968-1785 Application.pdf Permit#: 1785 Permit Date: 12/21/17 Permit Type: RESIDENTIAL MECHANICAL Project Name: Ingram Applicant Name: Nordstrom Heating &Air, Inc. Applicant Address: 4717 87th Ave NE Applicant, City, State, Zip: Marysville,WA 98270 Contact: Debbie Elgin Phone: 425-335-4029 Email: nordstromha@comcast.net Scope of Work: Install Ductless Heat Pump Valuation: 0.00 Square Feet: 0 Number of Stories: 0 Construction Type: Occupancy Group: ID Code: Permit Issued: 01/02/2018 Permit Expires: Form Permit Type: Status: LASERFICHE Assigned To: Kristin Foster Property Parcel# Address Legal Description Owner Name Owner Phone Zoning 00378800401100 103 N DUNHAM AVE INGRAM IRIS 111 Single Family Residence-Detached Contractors Contractor Primary Contact Phone Address Contractor Type License License# NORDSTROM 1059 State Ave. CONSTRUCTION HEATING&AIR INC 425-335-4029 Ste.G CONTRACTOR COA 601764617 NORDSTROM 1059 State Ave. CONSTRUCTION Labor&NORDSHA772L2 HEATING&AIR INC 425-335-4029 Ste.G CONTRACTOR Industries Inspections Date Inspection Type Description Scheduled Date Completed Date Inspector Status O1/31/2018 R00.HEAT PUMP/ 01/30/2018 BUILDING Completed AC UNIT FINAL Fees Fee Description Notes Amount Heat Pump/Heat Exchangers $25.00 Mechanical Base Permit Fee $25.00 Processing/Technology $25.00 Total $75.00 Attached Letters Date Letter Description 12/21/2017 Building Permit Payments Date Paid By Description Payment Type Accepted By Amount 12/21/2017 DANIEL NORDSTROM 67765778 cc $75.00 Outstanding Balance $0.00 Notes Date Note Created By: 12/22/2017 Emailed permit for signature Launa Black Uploaded Files Date File Name O1/31/2018 3001599-103 N Dunham Ave.docx O1/02/2018 2917481-1785 Issued Permit.jpg 12/21/2017 2870967-1785 Specs and Site Plan.pdf 12/21/2017 2870968-1785 Application.pdf