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19320 63rd Ave Ne_BLD1563_2026
PUGET SOUND CLEAN AIR AGENCY 1904 3rd Ave Ste 105 pscleanair.org Seattle WA 98101 -3317 Puget Sound Clean Air Agency (206) 689-4052 Fax: (206) 343-7522 <www.pscleanair.org> ENVIRONMENTAL CHECKLIST WAIT - You may not need to fill out the attached checklist. Please read and check the following: Because of the State Environmental Policy Act, the action for which you are filing a Notice of Construction and Application for Approval to this Agency requires the completion of an environmental checklist. BUT: If you can answer "yes" to either of the following statements with respect to the action being proposed, the attached checklist need not be completed: 1. 1 have obtained a State, City, or County Permit and filled out an environmental checklist. Yes ,/No If you answered "yes", give State, City or County Department, and date, and attach a copy of the checklist. 2. An environmental checklist or assessment s previously been filled out for another agency. Yes _ No If "yes", give agency and date, and attach a copy of the checklist. If your answer to both of the above statements is "no", you must complete the attached environmental checklist. Prepared by: Signature: . /� Uy Name of Signee: yy Woo Position and Agency/Organization: par`thw, /VO4tw-1 Date Submitted: % I� /Z-c,I 1 Form No. 50-150 (06/2015 NS) Page 1 of 14 Date: Proponent: Puget Sound Clean Air Agency Project, Brief Title: Environmental Checklist Purpose of Checklist: Governmental agencies use this checklist to help determine whether the environmental impacts of your proposal are significant. This information is also helpful to determine if available avoidance, minimization or compensatory mitigation measures will address the probable significant impacts or if an environmental impact statement will be prepared to further analyze the proposal. Instructions for Applicants: This environmental checklist asks you to describe some basic information about your proposal. Please answer each question accurately and carefully, to the best of your knowledge. You may need to consult with an agency specialist or private consultant for some questions. You may use "not applicable" or"does not apply" only when you can explain why it does not apply and not when the answer is unknown. You may also attach or incorporate by reference additional studies reports. Complete and accurate answers to these questions often avoid delays with the SEPA process as well as later in the decision-making process. 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. Instructions for Lead Agencies: Please adjust the format of this template as needed. Additional information may be necessary to evaluate the existing environment, all interrelated aspects of the proposal and an analysis of adverse impacts. The checklist is considered the first but not necessarily the only source of information needed to make an adequate threshold determination. Once a threshold determination is made, the lead agency is responsible for the completeness and accuracy of the checklist and other supporting documents. Use of checklist for nonproiect proposals: For nonproject proposals (such as ordinances, regulations, plans and programs), complete the applicable parts of sections A and B plus the SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (part Please completely answer all questions that apply and note that the words "project," "applicant," and "property or site" should be read as "proposal," "proponent," and "affected geographic area," respectively. The lead agency may exclude (for non-projects) questions in Part B - Environmental Elements—that do not contribute meaningfully to the analysis of the proposal. Form No. 50-150 (06/2015 NS) Page 2 of 14 TO BE COMPLETED BY THE APPLICANT A. BACKGROUND 1 . Name of proposed project, if applicable: 2. Name of applicant: H Cn,r/) &V Dv 3. Address and phone number of applicant and contact person: Name: P (rY+2�1 c� o Title: Firm: __ dd Telephoner( 7V aj l PO Box/Street: City/State/Zip: 4. Date checklist prepared: `�lcq _ 0I 'l 5. Agency requesting checklist: 6. Proposed timing or schedule (including phasing, if applicable). 7. Do you have any plans for future additions, expansion, or further activity related to or connected with this proposal? If yes, explain. NO 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. ` / ne- 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. M 10. List any government approvals or permits that will be needed for your proposal, if known. IL11 - 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. P TT C ,c ej '�a (jI�S 12. Location 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,#his checklist. /� 32-o 6 �r v Iv f- Form No. 50-150 (06/2015 NS) a �-f I�_j`/-�v1 tVq %'Z Page 3 of 14 B. ENVIRONMENTAL ELEMENTS 1. Earth a. General desc, riptlon of the site (flat, rolling, 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 agricultural land of long-term commercial significance and whether the proposal results in removing any of these soils. d. Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe. /1 p e. Describe the purpose, type, total area, and approximate quantities and total affected area of any filling, excavation, and grading proposed. Indicate source of fill. IVIA 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)? ot/1 a5r11-16_/ 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 woodsmoke, greenhouse gases) during construction, operation, and maintenance when the project is completed? If any, generally describe and give approximate quantities, if known. /t/p n4K_ b. Are there any off-site sources of emissions or odor that may affect your proposal? If so, generally describe. �r Form No. 50-150 (06/2015 NS) Page 4 of 14 c. Proposed measures to reduce or control emissions or other impacts to air, if any: 3. WATER a. Surface 1) 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. Av0 2) 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. hO 3) 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. 0114 4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known. IVO 5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan. po 6) Does the proposal involve any discharges of waste materials to surface waters? If so, describe the type of waste and anticipated volume of discharge. �p b. Ground Water 1) Will groundwater be withdrawn from a well for drinking water or other purposes? If so, give a general description of the well, proposed uses and approximate quantities withdrawn from the well. Will water be discharged to groundwater? Give general description, purpose, and approximate quantities, if known. r 0 2) 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 systems, 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. /j/M Form No. 50-150 (06/2015 NS) Page 5 of 14 c. Water Runoff (including stormwater) 1) Describe the source of runoff (including stormwater) 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. C2740r-A,, G(VA 11--t 5 2) Could waste material enter ground or surface waters? If so, generally describe. 40 3) Does the proposal alter or otherwise affect drainage patterns in the vicinity of the site? If so, describe. ,' O d. Proposed measures to reduce or control surface, ground, and runoff water, and drainage pattern impacts, impacts, if any: /V/ 4. Plants a. Check the types of vegetation found on the site: _ deciduous trees: _ alder _ maple _ aspen other (specify): evergreen trees: _ fir _ cedar _ pine other (specify): _ shrubs grass pasture crop or grain orchards, vineyards or other permanent crops _wet soil plants: _ cattail _ buttercup _ bullrush _ skunk cabbage _ other (specify): water plants: _water lily _ eelgrass _ milfoil other (specify): other types of vegetation (specify): b. What kind and amount of vegetation will be removed or altered? IVIA c. List threatened or endangered species known to be on or near the site. IT Form No. 50-150 (06/2015 NS) Page 6 of 14 d. Proposed landscaping, use of native plants, or other measures to preserve or enhance vegetation on the site, if any: /vIA e. List all noxious weeds and invasive species known to be on or near the site. /V//1 5. Animals a. Indicate birds and other animals that have been observed on or near the site or are known to be on or near the site. _ Birds: _ hawk _ heron _ eagle _ songbirds _ other (specify): Mammals: _ deer _ bear _ elk _ beaver _ other (specify): _ Fish: _ bass _ salmon _trout _ herring _ shellfish _ other (specify): 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: e. List any invasive animal species known to be on or near the site. 6. Energy and Natural Resources a. What kinds of energy (electric, natural gas, oil, woodstove, solar) will be used to meet the completed project's energy needs? Describe whether it will be used for heating, manufacturing, etc. t (c j-,�` -10 �d`tee" ee� b. Would your project affect the potential use of solar energy by adjacent properties? If so, generally describe. Avo 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: u ,L Lew � cc" S �G`r`'�S 44-112- � W I-JOS Form No. 50-150 (06/2015 NS) Page 7 of 14 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: P 0 1) Describe any known or possible contamination at the site from present or past uses. 2) Describe existing hazardous chemicals/conditions that might affect project development and design. This includes underground hazardous liquid and gas transmission pipelines located within the projec �rea and in the vicinity. �[C/� 3) Describe any toxic or hazardous chemicals that might be stored, used, or produced during the project's development or construction, or at any time during the operating life of the project. kJ cr-� 4) Describe special emergency services that might be required. ACgR__ 5) Proposed measures to reduce or control environmental health hazards, if any: b. Noise 1) What types of noise exist in the area that may affect your project (for example, traffic, equipment, operation, other)? /U(9 M_Q_ 2) 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. X_L� 3) 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? Will the proposal affect current land uses on n arby or adjacent pr perties? If so, describe. �1( (( `t O4 a4e cv (CA-V..-4U b. Has the project site been used as working farmlands or working forest lands? If so, describe. How much agricultural or forest land of long-term commercial significance will be converted to other uses as a result of the proposal, if any? If resource lands have not been designated, how many acres in farmland or forest land tax status will be converted to nonfarm or nonforest use? Form No. 50-150 (06/2015 NS) Page 8 of 14 1) Will the proposal affect or be affected by surrounding working farm or forest land normal business operations, such as oversize equipment access, the application of pesticides, tilling, and harvesting? If so, how? , -/A c. Describe any structures on the site. d. Will any structures be demolished? If so, what? j/(,Q 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 a critical area by the city or community? If so, specify. /„e? 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: I. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if any: m. Proposed measures to ensure the proposal is compatible with nearby agricultural and forest lands of long-term commercial significance, if any: 9. Housing a. Approximately 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. Form No. 50-150 (06/2015 NS) Page 9 of 14 c. Proposed measures to reduce or control housing impacts, if any: 10. Aesthetics 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? 4*1 c. Proposed measures to reduce or control aesthetic impacts, if any: 11. Light and Glare a. What type of light or glare will the proposal produce? What time of day would it mainly occur? hv-Lg___ b. Could light or glare from the finished project be a safety hazard or interfere with views? 1V11q c. What existing off-site sources of light or glare may affect your proposal? &1� d. Proposed measures to reduce or control light and glare impacts, if any: 12. Recreation 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. 1111114 c. Proposed measures to reduce or control impacts on recreation, including recreational opportunities to be provided by the project or applicant, if any.. 13. Historic and Cultural Preservation a. Are there any buildings, structures, or sites, located on or near the site that are over 45 years old listed in or eligible for listing in national, state, or local preservation registers located on or near the site? If so, specifically describe. /v Form No. 50-150 (0612015 NS) Page 10 of 14 b. Are there any landmarks, features, or other evidence of Indian or historic use or occupation? This may include human burials or old cemeteries. Are there any material evidence, artifacts, or areas of cultural importance on or near the site? Please list any professional studies conducted at the site to identify such resources. AI-A c. Describe the methods used to assess the potential impacts to cultural and historic resources on or near the project site. Examples include consultation with tribes and the department of archeology and historic preservation, archaeological surveys, historic maps, GIS data, etc. 40f d. Proposed measures to avoid, minimize, or compensate for loss, changes to, and disturbance to resources. Please include plans for the above and any permits that may be required. 2/1A 14. Transportation a. Identify public streets and highways serving the site or affected geographic area and describe proposed access to the existing street system. Show on-site plans, if any. //20 6C(3!5e b. Is site or affected geographic area currently served by public transit? If so, generally describe. If not, what is the approximate distance to the nearest transit stop? bu.Gj Ca,7t4— blo&G 5 acva c. How many parking spaces would the completed project or non-project proposal have? How many would the project or proposal eliminate? V d. Will the proposal require any new or improvements to existing roads, streets, pedestrian, bicycle or state transportation facilities , not including driveways? If so, generally describe (indicate whether public or private). QUO e. Will the project use (or occur in the immediate vicinity of) water, rail, or air transportation? If so, generally describe./to f. How many vehicular trips per day would be generated by the completed project or proposal? If known, indicate when peak volumes would occur and what percentage of the volume would be trucks (such as commercial and nonpassenger vehicles). What data or transportation models were used to make these estimates?Ao�-5 g. Will the proposal interfere with, affect or be affected by the movement of agricultural and forest products on roads or streets in the area? If so, generally describe. Form No. 50-150 (06/2015 NS) Page 11 of 14 h. 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, public transit, health care, schools, other)? If so, generally describe. 4(9 b. Proposed measures to reduce or control direct impacts on public services, if any: 16. Utilities a. Indicate utilities currently available at the site: electricity " to phone _ na ural gas sanitary sewer _water septic system refuse service _ other (specify): b. Describe the utilities that are proposed for the project, the utility providing the service, and the general construction activities on the site or in the immediate vicinity that might be needed. �G� e C. SIGNATURE The above answer re true and complete to the best of my knowledge. I understand that the lead agencyr yin on them to make its decision. Signature: II ll Name of Signee: 44avo C4/00 Position and Agency/Organization: pq 4t7 w 1Vov rcu/ 4-6c, Date Submitted: Vd�/ )-0 (7 Form No. 50-150 (06/2015 NS) Page 12 of 14 D. SUPPLEMENTAL SHEET FOR NON-PROJECT ACTIONS (Do not use this sheet for project 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 substance; or production of noise? Proposed measures to avoid or reduce such increases are: 2. How would the pro d proposal be likely to affect plants, animals, fish, or marine life? �f C"/O w( 0 Q�l 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? ,no i f c,-,( ,( 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? 0 Ao — Proposed measures to protect such resources or to avoid or reduce impacts are: Form No. 50-150 (06/2015 NS) Page 13 of 14 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? (-f/0C'( a, h0- - Ct7C� 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? no 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.` vqa Form No. 50-150 (06/2015 NS) Page 14 of 14 G1�y COMMERCIAL REMODEL lN o 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.KTenant Type of Permit: ( ) Commercial Remodel ( ) Commercial Addition Improvement Project Address: 19320 20 00 &e= li ?gaz3 Parcel ID#: Project Description: AIJW-0114114502 r'i2 104a'-I?- Legal Description: Project Valuation: O©O tu Owner: /" �/� ��dI�CJ L��l, Phone Number: Address: /� City: State: Zip Code: q Contact Person: ("W J AIF- - (nyNL<— Phone Number: Cell Phone: E-mail: Address: City: Q,I " State:JL)A— Zip Code: Contractor: Phone Number: Address: City: State: Zip Code: Contractors License Number: Expiration: Plumbing Contractor: Phone Number: Address: City: State: Zip Code: Contractors License Number: Expiration: Mechanical Contractor: Phone Number: Address: City: State: Zip Code: Contractors License Number: Expiration: Received JUL 2 4 2017 ?.�b (s�3 REV 2015 Page 6 of 7 Y O� COMMERCIAL REMODEL f�G1o� PERMIT APPLICATION Department of Community&Economic Development City of Arlington • 18204 59th Ave NE•Arlington, WA 98223 • Phone(360)403-3551 Project Name/Tenant C--Popi GLc Site Address 7 1' i Bldg./Unit/Suite IBC Construction Type f Notit-�liri D IBC Occupancy Type f Description of Use G-124GUI 6141ZA-Mrrl) -r Building Square Footage 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 ordipping 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. Applicants Signature Ki��OAR (-MAk'�_ -71141 � Print Applicants Name Date FOR STAFF USE ONLY 1G63 Permit# Accepted By Amount Received Receipt# Date Received REV 2015 Page 7 of 7 CITY OF ARLINGTON 238 N. OLYMPIC AVE-ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:19320 63rd Ave NE Permit#:1563 Parcel#:31051500401200 Valuation:50000.00 OWNER APPLICANT CONTRACTOR Name:CITY OF ARLINGTON Name:Kenneth Gong Name:MS Construction Address: 18204 59TH DRIVE NE Address:2617 98th Place SE Address: 15625 264th Street E City,State Zip:ARLINGTON,WA 98223 City,State Zip:Everett,WA 98208 City,State Zip:Graham,WA 98338 Phone: Phone:26-295-8833 Phone: MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City,State,Zip: City,State,Zip: Phone: Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Tenant Improvement 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 110/IRC 110. SALE'TA.'N T[ E:Sales tax relating to construction and construction materials in thcCti Arligg�mus reported on your sales tax return form and c ed ngton#3101. Alnl NCI Signature Print Name Date Released By Date CONDITIONS See red lined drawings.Adhere to approved plans. Additional requirements/comments: Contact the Wastewater Department at 360-403-3539 for pretreatment requirements.A 2" water service connection is required for this building and will need to be separately 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 8/9/2017 Building Permit Fee $1,091.60 8/9/2017 Building Plan Review Fee $592.66 8/9/2017 Processing/Technology Fee $25.00 8/9/2017 State Building Code Surcharge Fee $4.50 Total Due: $1,713.76 Total Payment: $592.66 Balance Due: $1,121.10 CALL FOR INSPECTIONS BUILDING(360)403-3417 D2 DREREMD ED PROJECT INFORMATION: PROJECT LOCATION: 19320 63rd AVE NE,ARLINGTON WA 98223 PARCEL#: 31051500401200 STORAGE D3 PROJECT CONTACT: PETER CHOPELAS P.E. R�E�M'G N1 N3 302 N. OLYMPIC AVE#208 ARLINGTON,WA 98203 EXISTI.. Eo TDREREM (360)653-4615 N1 CHOPELASAND ASSOCIATES@GMAIL.COM APPLICANT: NORTHERN GROW, LLC 19320 63RD AVE NE BREAK ROOM EN DRYING/CURING ARLINGTON, WA 98223 ROOM KEN GONG Drrl (206)295-8833 D3 KENHG@HOTMAIL.COM SECURItt/D3 STORAGE EXIST.LOADIrvGNrv-LOADING EXIST DR D3 Dz EXISTING BUILDING 13,895±SF EXISTING ROOM #4 MEZZ. PLAN EXISTING FLOOR PLAN NORTH—� CLONING ROOM D3 ROOM #2 ROOM #3 1/16"=1'-0" 1/16"=V-0" N1 N1 ROOM #1 D3 D3 N1 MEN N1 00 0� N1 WOM N1 D3 - ROOM #6 N1 EXIST.OFFICE D3 N1 D3 ROOM #5 D3 EXIST.LOADING/UN-LOADING EXISTING EXISTING BUILDING EXTERIOR 13,895±SF EXIST.LOBBY YARD 4,906±SF ROLL-UP DOOR ENTRY D1 PROPOSED FLOOR PLAN NORTH STRUCTURAL NOTES: --� A. GENERAL: D. FOUNDATION DATA: 1/16"=1'-0" 1.These notes are supplementary and do not supersede the 1.Existing slabs acts as acceptable footings for interior walls and columns. specifications and details on the drawings. E. TIMBER FRAMING NOTES: 2.Zoning:industrial, EXIST.FENCE AND GATE 3.Building Group F-1 1.Hem-Fir No.2 or Doug-Fir No.2 for joists,rafters,and framing to 4"width. 4.Sprinkler system required 2.Hem-Fir or Doug-Fir,Utility or No.3 or better for plates and blocking. PROPOSED NEW GROW ROOMS 5.Type of Construction:V(non rated) 3.Joists and rafters to have 2"thick solid blocking at bearing supports. ROOM#1 2,300 SF (40) (29-4x8) (11-4x6) 4.Provide washers for all bolts bearing on wood. A 6.Grow rooms Ag occupancy 300 SI loccupant,class C wiling ROOM#2 1,850 SF (33) (28-4x8) (5-4x6) and wall finish 5.All nails are common wire nails.Nailing not otherwise noted should be "N EXISTING FRONT YARD/PARKING ROOM#3 1,500 SF (24) (22-4x8)(2-4x6) B. CODES 8 STANDARDS: per IBC Table 2304.9.1 } 'C ROOM#4 2,100 SF (36) (36-4x8) 1.2015 International Building Code(IBC);ASCE7 F. MISCELLANEOUS:1. ROOM#5 990 SF (17) (17-4x8) 2.2015 International Mechanical Code Contras or to verify all dimensions in the field. 2.Provide temp.bracing as required until all permanent connections are . . . . . . ROOM#6 1,260 SF (22) (22-4x8) 3.Washington State Energy Code installed. C. DESIGN LOADS: 3.Pre-fabricated trusses,hold downs,hangers,and other items to be installed 63RD AVE NE 10,000 SF (172) (154-4x8)(18-4x6) oar the manufacturers recommendations. 1.Seismic Site Class...............................D,Sds=0.763 2.Wind Speed......................................110 mph,Exposure"B" 3.Floor load(slabe-on-grade)...................125 PSF EXISTING SITE PLAN NORTH 4.Ceiling area loads..................................25PSF SHEET 1 OF 3 N.T.S. 5.Soil bearing capacity...........................2,000 psf 118' 28'-1" 38'-3" 20,-10" 28'-2" U 16'-11" 21'4" EXISTING DOOR 14'-1" 14'-1" axo O 14,-1" 14'-1" TO BE REMOVED D2 R1 m U 0 O 58"X13 "GLB mG AN 12'-4" p 0 12'-6" 12,4„ °x° 14' 14'-1" 14'-1" fO+� 19,-6" m 5 X 13 2'GLB • 5 e"X 13 z"GLB a x� ■ 23'4" ■ UO 58'X13}"GLB a 19' 19' � 11 tO 11 co O 16'-9" 58"X13�'GLB c� IF--9 N x 14' m Lo @ ci Ud O ■ 5 X13#"GLB N m 5 X13 "GLB N X ■ N1 19'-3" Lo c C7 O O M 14' 14' 72'-8" 75'-3" x • 19,_3„ • EXISTING aoBREAK 80'-2" EXISTING DRYIY6&(RING 5 "X 131"GLB N 5 J"X 13�'GLB N DRYI0I6E&IRING ROOM ROOM �1Q U U m 17 GOB ■ O O • EXISTING D 30R m @ TO BE REM VED 6+ 2x8 @ 16"O.C. J 2x8 @ 16"O.C. axo x x �n 5g„X13 "GLB N 5 X13 "GLB N fin■ R1 �e • X 2x8 @ 16"O.C. 2x8.@ 16"O.C. 19'4- 0�,. D3 D2 117'-9 G ;n U ROOM #4 ' ' ROOM #4 U m ��� CLONING ROOM O O C7 ro+ CLONING ROOM 14 ROOM #2 14 ROOM #3 �_ M D3 ROOM #2 ROOM #3 19'-7" ■ x m cx v � N1 N1 J RO M #1 44. ROOM #1 D3 D3 N1 MEN'S r EN 29,_8" 7'-3"9'_2„ x N1O O N1 0WOOMEN' m 4 8 �WOOM N1 R OM #6 2'-9" D3 ROOM #6 12' m N1 18' EXIST.OFFICE X EXIST.OFFICE D3 N1 15' �e x 2x8 @ 16"O.C. � 2x8 @ 16"O.C. C� 2x8 16"O. AGO 41' ■ �i ROO #5 D3 36'-8' 12' 6+� ROOM #5 x • D3 �e ■ 14'-8" 9'-4" 14'-1" 14'-1" m m 2x8 @ 16'O.C. 2x8 @ 16"O.C. 29'-5' G ti co EXIST.LOADING/UN-LOADING m• EXIST.LOADING/UN-LOADING x • cl) le 18' 16,_9" M EXIST.LOBBY M x EXIST.LOBBY 12 x m ROLL-UP DOOR ENTRY ROLL-UP DOOR ENTRY 14'-6" 14'-8" 9'-4" 14'-1" 14'-1" I 19,_2„ I D1 := 29'-5" 12,-T13'-8_" 4'4" 38'-6" 28'-2" CEILING PLAN NORTH FRAMING PLAN NORTH-� 1/8"=114„ 1/8"=1'-0" DOOR SCHEDULE D1 EXISTING METAL ENTRY DOOR/3'-0" . D2 EXISTING METAL EXIT DOOR/3'-0" 4 D3 EXISTING INTERIOR WOOD DOOR/3'-0" __ 4� N1 NEW METAL DOOR/3'-O" N2 NEW METAL SECURITY DOOR/3'-O" N3 NEW METAL DOOR/2'-6" R1 EXISTING DOOR TO BE REMOVED AND FRAMED SHEET 2 OF 3 EH "OSB W/8d NAILS @ 6"O.C. SIMPSON L28 HANGERS AT ALL EDGES AND MEMBERS. 2x8 HF @ 16"O.C. FRAMING JOISTS W/(3)TOE NAIL AT EACH JOIST TO TOP PLATE 2x8 LEDGER W/(3) 2x8 RIM W/8d TOE LEDGER LOCK, NAIL @ 6"O.C. 5"EMBEDMENT 2x8 BLKG.BTWN JOISTS ffl (3) 10d TOE NAIL INT.WALL AND CEILING 5 8"x13 Z"GLB 16"OSB W/8d NAILS FINISH(FASTEN PER E @ 6"O.C.ON ALL EDGES. MFR REQ. EXISTING EH BREAK HORIZ.BLOCKING REQ. @ HORIZ.EDGES SIMPSON PC68 POST CAP EXISTING ROOM NG WALL ROOM CD 6x8 POST HF#2 2x4 WALL FRAMING GROW ROOM GROW ROOM @ 16"O.C. POST BASE CONNECTOR W/(2)SIMPSON ABU68 10'-0"CEILI G HT. 8'-0"CEIL.HT. PT 2x4 W/Z"SIMPSON POST BASE. STRONG-BUILT WEDGE BOLT INTO CONCRETE, ANCHOR(2 "DEEP MIN.) 2t'MIN.EMBED ROOM #4 @ 4'-0"O.C. EXIST.CONC.FLOOR CLONING ROOM a d G ROOM #2 E H ROOM e HA <n. e. o.. a a4. ® 10'-0"CEILING HT. 10'-0"CEILING H . <,n n <.a 10'-0"CEILING HT. 8'-0"CEIL.HT. ROOM #1 F MEWS 25'-0"CEIL HT. HT. E" Ll J 25'-0"CEIL.HT. TYPICAL WALL SECTION 25'-0"CEIL.HT q WOMEN' ro 8'-0"HT. ROOM #6 1"=1'-0" 10'-0" EILING NOTE: ® ® EXIST. ALL FRAMED GROW ROOM WALLS SHOULD BE SHEATHED W/7/16"OSB,NAILED W/8d NAILS @ 6"O.C. ON ALL EDGES. HORIZONTAL 2x BLOCKING REQUIRED 8'-0"CEIL.HT. 10'-0"CEILING HT. ROOM #5 AT ALL HORIZONTAL EDGES. 25'-0"CEIL.HT. EXIST.LOADING/UN-LOADING ® ® EXIST.LOBBY 8'-0"CEIL.HT. ROLL-UP DOOR ENTRY MECHANICAL PLAN NORTH h MECHANICAL SCHEDULE Y ® EXIST. 2X4 CEILING MOUNT FLOURESCENT FIXTURE I NEW EXHAUST o-- NEW FRESH AIR INTAKE SHEET 3 OF 3 Peter Chopelas, PE Engineering &Design Services 307 North Olympic Ave, Suite#208 Arlington, WA 98223 (360) 653-4615 Chopelasandassociates@gmail.com July 24, 2017 Kenny Gong, 206-295-8833 Northern Grow LLC, 18415 Occidental Ave S Burien,WA 98148 Subject:Conversion and alterations to existing commercial building for indoor growing production at 19320 63rd Ave NE, Arlington WA The lateral and vertical loads were analyzed for the changes to building according to the requirements of the 2015 International Building Code (ASCE 7-10). Note; the structural provisions of the 2015 IBC has not changed from the 2012 IBC. The following design conditions for the analysis are based on the site conditions or according to the minimum code requirements: Soil Bearing Capacity: 2,000 Lbs per SF. Ceiling live load: 25 PSF Floor load(slabe-on-grade) 125 PSF Wind Exposure/Importance: no wind exposure to internal changes Seismic Site Class: D, Sds =0.763 The shear loads on the internal walls and structure are due to seismic loading. All the stouter shown on the plans are more than adequate to brace the integral grow room structures. If you have any questions or are in need of further assistance please feel free to call. Fitta Peter Chop elas PE Desig;iiMaps 5tmunaryReport htips://earthquake.usgs.gov/cnl/desigiunaps/us/stuiimary.plip?template... �USGS Design Maps Summary Report User—Specified Input Report Title Norther Grow tenet improvments Thu July 20, 2017 23:49:36 UTC Building Code Reference Document 2012/2015 International Building Code (which utilizes USGS hazard data available in 2008) Site Coordinates 48.17170N, 122.14657°W Site Soil Classification Site Class D - "Stiff Soil" Risk Category I/II/III Stanwood, '�� ` EQEY HILL NA VA L POP I STILCAGUi��trSH RESfRVAROM 5>✓15:,N RESfR TJW r BAY Arlington no `Warm Beach Ji �Ar?1 1NGTONd S!UWAI. P*J.4T �i _ � y T VIAL P RESMATION ,Granite Falls USGS—Provided Output Ss = 1.066 g SN,s = 1.145 g Sps = 0.763 g S, = 0.415 g Sm, = 0.658 g S,, = 0.439 g For information on how the SS and S1 values above have been calculated from probabilistic (risk-targeted) and deterministic ground motions in the direction of maximum horizontal response, please return to the application and select the "2009 NEHRV building code reference document. 4�:-•,�.�.;.;;.:.n"L�"Ci't>.J'�i � 'i to rs;:�(� ,':• -n � ._r a7e•_;�.1. _� 5L She. "��-ri (Las 37 CM Q72 ew ac>• ctai o ;n QG7 O a!0 N Q{tl C-32 a rLIN Q10 ab7 as.•o Qw Q4J QA7 1.00 1 W 1.10 r.eo 1Al zoo QQ7 aza Qea QUJ 007 t.o7 l..n 1-40 I.Ca Lao uro.! Perio9"r(.see) fIErE:� ,T _ Although this information is a product of the U.S. Geological Survey, we provide no warranty, expressed or implied, as to the accuracy of the data contained therein.This tool is not a substitute for technical subject-matter knowledge. 1 of 1 7/20/2017 4:49 PM Co,-763) 17 �1 Ai i 35500 r� Project:grow rooms Peter Chopelas Location:typical ceiling beam ` = Chopelas and associates / Multi-Span Floor Beam j 307 N.Olympic Ave,suite 208 [2012 International Building Code(2012 NDS)] Arlin ton,WA 98223 a 5.125 IN x 13.5 IN x 21.33 FT •y_ g 24F-V4-Visually Graded Western Species-Dry Use StruCalc Version 9.0.2.5 7/24/2017 11:15:59 AM Section Adequate By: 7.0% Controlling Factor:Moment DgFLECTIONS Center LOADING DIAGRAM Live Load 0.86 IN U297 Dead Load 0.38 in Total Load 1.24 IN U206 Live Load Deflection Criteria: L/180 Total Load Deflection Criteria: U120 REACTIONS 6 B Live Load 3733 lb 3733 lb Dead Load 1653 lb 1653 lb Total Load 5386 lb 5386 lb Bearing Length 1.62 in 1.62 in BEAM DATA Center Span Length 21.33 ft — — - —_—_ Unbraced Length-Top 0 ft -Q 21.33 ft g Unbraced Length-Bottom 21.33 ft Floor Duration Factor 1.00 Camber Adj.Factor 1.5 Camber Required 0.57 FLOOR LOADING Center Notch Depth 0.00 Floor Live Load FILL= 25 psf MATERIAL PROPERTIES Floor Dead Load FDL= 10 psf Floor Tributary Width Side One TW1 = 7 ft 24F-V4-Visually Graded Western Species Floor Tributary Width Side Two TW2= 7 ft Base Values dusted Wall Load WALL= 0 plf Bending Stress: Fb= 2400 psi Controlled by: Fb_cmpr= 1850 psi Fb'= 2368 psi BEAM LOADING Center Cd=1.00 Cv=0.99 Reduced Floor Live Load 25 psf Shear Stress: Fv= 265 psi Fv'= 265 psi Total Live Load 350 plf Cd=1.00 Total Dead Load 140 plf Modulus of Elasticity: E= 1800 ksi E'= 1800 ksi Beam Self Weight 15 plf Comp.1 to Grain: Fc--L= 650 psi Fc-1'= 650 psi Total Load 505 plf Controlling Moment: 28720 ft-lb 10.66 Ft from left support of span 2(Center Span) Created by combining all dead loads and live loads on span(s)2 Controlling Shear: 5386 lb At left support of span 2 (Center Span) Created by combining all dead loads and live loads on span(s)2 Comparisons with required sections: Read Provided Section Modulus: 145.53 in3 155.67 in3 Area(Shear): 30.49 in2 69.19 in2 Moment of Inertia(deflection): 636.76 in4 1050.79 in4 Moment: 28720 ft-lb 30722 ft-lb Shear: 5386 lb 12223lb NOTES Project:grow rooms k �1 case --Xv._ 7PeterChopelas Location:COL3 Chopelas and associates Column 307 N.Olympic Ave,suite 208 a [2012 International Building Code(2012 NDS)] —Arlington,WA 98223 5.5 IN x 7.5 IN x 9.0 FT � #2- Hem-Fir-Dry Use StruCalc Version 9.0.2.5 7/24/2017 11:16:21 AM Section Adequate By: 19.4% VERTICAL REACTIONS LOADING DIAGRAM Live Load: Vert-LL-Rxn= 7000 lb Dead Load: Vert-DL-Rxn= 2869 lb Total Load: Vert-TL-Rxn= 9869 lb COLUMN DATA Total Column Length: 9 ft B Unbraced Length(X-Axis)Lx: 9 ft Unbraced Length(Y-Axis)Ly: 9 ft Column End Condtion-K(a): 1 Load Eccentricity(X-Axis)-ex: 0.5 in Load Eccentricity(Y-Axis)-ey: 0.5 in Axial Load Duration Factor 1.00 COLUMN PROPERTIES #2 -Hem-Fir Base Values Adiusted Compressive Stress: Fc= 575 psi Fc'= 464 psi Cd=1.00 Cp=0.81 9�� Bending Stress(X-X Axis): Fbx= 575 psi Fbx'= 573 psi Cd=1.00 CF=1.00 CI=1.00 Bending Stress(Y-Y Axis): Fby= 575 psi Fby'= 575 psi Cd=1.00 CF=1.00 Modulus of Elasticity: E= 1100 ksi E'= 1100 ksi Column Section(X-X Axis): dx= 7.5 in Column Section(Y-Y Axis): dy= 5.5 in Area: A= 41.25 in2 Section Modulus(X-X Axis): Sx= 51.56 in3 Section Modulus(Y-Y Axis): Sy= 37.81 in3 - Slenderness Ratio: Lex/dx= 14.4 -A Ley/dy= 19.64 Column Calculations(Controlling Case Only): AXIAL LOADING Live Load: PL= 7000 lb Controlling Load Case:Axial Total Load Only(L+D) Dead Load: PD= 7000 lb Actual Compressive Stress: Fc= 239 psi W 69 lb Column Self Weight: CS = Allowable Compressive Stress: Fc'= 464 psi Total Load: CS= 9869 lb Eccentricity Moment(X-X Axis): Mx-ex= 408 ft-lb Eccentricity Moment(Y-Y Axis): My-ey= 408 ft-lb Moment Due to Lateral Loads(X-X Axis): Mx= 0 ft-lb Moment Due to Lateral Loads(Y-Y Axis): My= 0 ft-lb Bending Stress Lateral Loads Only(X-X Axis): Fbx= 0 psi Allowable Bending Stress(X-X Axis): Fbx'= 573 psi Bending Stress Lateral Loads Only(Y-Y Axis): Fby= 0 psi Allowable Bending Stress(Y-Y Axis): Fby'= 575 psi Combined Stress Factor: CSF= 0.81 NOTES r,? n Project:grow rooms IL 11 -JF 01 Peter Chopelas Location: ceiling joist Chopelas and associates / Floor Joist 307 N.Olympic Ave,suite 208 [2012 International Building Code(2012 NDS)] �;:,� --=Arlington,WA 98223 1.5 IN x 7.25 IN x 14.2 FT @8O.C. #2- Hem-Fir-Dry Use StruCalc Version 9.0.2.5 7/24/2017 11:16:47 AM Section Adequate By: 131.6% Controlling Factor: Moment DEFLECTIONS Center LOADING DIAGRAM Live Load 0.25 IN U692 Dead Load 0.08 in Total Load 0.32 IN U524 Live Load Deflection Criteria: L/180 Total Load Deflection Criteria: U120 REACTIONS A B Live Load 118 lb 118 lb Dead Load 38 lb 38 lb Total Load 156 lb 156 lb Bearing Length 0.26 in 0.26 in SUPPORT LOADS A 8 Live Load 177 plf 177 plf - Dead Load 57 plf 57 plf 14.2 ft Total Load 234 pif 234 plf A MATERIAL PROPERTIES #2-Hem-Fir JOIST DATA Center Rase Values Adjusted Span Length 14.2 ft Bending Stress: Fb= 850 psi Fb'= 1173 psi 1nbraced Length-Top 0 ft Shear Stress: Fv= 50 ps Cd=1.00 C50 psi Cr--Cr--i Fv' Unbraced Length-Bottom 0 ft = 150 psi Floor sheathing applied to top of joists-top of joists fully braced. Cd=1.00 Sheathing/sheetrock applied to bottom ofjoists-bottom ofjoists fully braced. Modulus of Elasticity: E= 1300 ksi E'= 1300 ksi Floor Duration Factor 1.00 Comp.-L to Grain: Fc--L= 405 psi Fc--L'= 405 psi JOIST LOADING Controlling Moment: 555 ft-lb Uniform Floor Loading Center 7.1 Ft from left support of span 2(Center Span) Live Load LL= 25 psf Created by combining all dead loads and live loads on span(s)2 Dead Load DL= 8 psf Controlling Shear: 156 lb Total Load TL= 33 psf At left support of span 2(Center Span) TL Adj. For Joist Spacing wT= 22 plf Created by combining all dead loads and live loads on span(s)2 Comparisons with required sections: Read Provided Section Modulus: 5.67 in3 13.14 in3 Area(Shear): 1.56 in2 10.88 in2 Moment of Inertia(deflection): 12.39 in4 47.63 in4 Moment: 555 ft-lb 1284 ft-lb Shear: 156 lb 1088lb NOTES r IL ; a 4 .1 'T -t _ - � I ` ♦ � `� ` .jam,,'{ A.,,_` � � l -W Lr ol 41 _I � r t `` / • �Z+w•'i�^RY 11� 17a. 'I ,�-j �t'� I�1_ ,t—� -'. � _ ___ _Ar! � 4� � far • .� .• _ �;�, ., �'� � < .' - - f ■fin Q _ o ■ . nIR7r 1 - r ° �► -.i-t• l ill _ t � , .T rZ=• `. hf_' is ,� ,. f - I � ♦ W* FZ It AM ,Ir- lio lip 00%- 16 Ilk � ,�; ,..���•' j .. - _ . yftiFR� .ram 'F- : .. r ��;}� �1� .7 �► t _ n - ' CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:19320 63rd Ave NE Permit#:1563 Parcel#:31051500401200 Valuation:50000.00 OWNER APPLICANT CONTRACTOR Name:CITY OF ARLINGTON Name:Kenneth Gong Name:MS Construction Address: 18204 59TH DRIVE NE Address:2617 98th Place SE Address: 15625 264th Street E City,State Zip:ARLINGTON,WA 98223 City,State Zip:Everett,WA 98208 City,State Zip:Graham,WA 98338 Phone: Phone:26-295-8833 Phone: MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City,State,Zip: City,State,Zip: Phone: Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Tenant Improvement 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 110/IRC 110. SALE. 7'A NOTI 'E:Sales tax relating to construction and construction materials in the, Arli—n2b mus b reported on your sales tax return form and�on#3101. Signature Print Name Date Released By Date CONDITIONS See red lined drawings. Adhere to approved plans. Additional requirements/comments: Contact the Wastewater Department at 360-403-3539 for pretreatment requirements. A 2" water service connection is required for this building and will need to be separately 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 8/9/2017 Building Permit Fee $1,091.60 8/9/2017 Building Plan Review Fee $592.66 8/9/2017 Processing/Technology Fee $25.00 8/9/2017 State Building Code Surcharge Fee $4.50 Total Due: $1,713.76 Total Payment: $592.66 Balance Due: $1,121.10 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 8/9/2017 M S CONSTRUCTION search L&I Health Clam-is& Inskjrancr: M xk aifice rights ades k L cerE<,inq AAk Washington State Department of kj Labor & Industries M S CONSTRUCTION Owner or tradesperson 15625 264TH ST E Principals GRAHAM,WA 98338 360-893-1616 SWEET,MICHAEL J,OWNER PIERCE County Doing business as M S CONSTRUCTION WA UBI No. Business type 601 300 838 Individual Governing persons MICHAEL JOSEPH SWEET MICHELLEANN SWEET; 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. MSCON-099KA Effective—expiration 05/01/1991—07/17/2019 Bond Western Surety Co $12,000.00 Bond account no. 62798535 Received by L&I Effective date 06/2712016 06/17/2016 Expiration date Until Canceled Bond history Insurance Endurance American Specialty 1 $1,000,000.00 Policy no. CBC20002096200 Received by L&I Effective date 02/17/2017 02/26/2017 Expiration date 02/26/2018 Insurance history Savings (in lieu of bond) $6,000.00 Received by L&I Effective date ;1elp -is improv,, https://secure.ini.wa.gov/verify/Detail.aspx?UBI=601300838&LIC=MSCON""099KA&SAW= 1/3 8/9/2017 M S CONSTRUCTION 05/06/1991 05/01/1991 Release date Impaired date N/A N/A Savings account ID 3017028865 Lawsuits against the bond or savings Cause no. 13-2-05543-6 Dismissed Complaint filed by Complaint against bond(s)or savings MANOR HARDWARE INC 46BCO27198 Complaint date Complaint amount 0112 5/2 0 1 3 $9,507.86 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 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 Call L&I account representative for account 892,443.00 status. Doing business as M S CONSTRUCTION Estimated workers reported Incomplete premium report received. L&I account contact T4/JAMIE COLLINS(360)417-2711-Email:COJA235@lni.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 Check for any past safety and health violations found on jobsites this business was responsible for. Inspection results date 03/30/2015 Violations Inspection no. 317935638 Location 19001 Trilogy Parkway Bonney Lake,WA 98391 Inspection results date 12/16/2013 Violations Inspection no. 316910454 Location 3504 N Pearl St. Tacoma,WA 98407 Inspection results date 03/20/2013 Violations Inspection no. https://secure.ini.wa.gov/verify/Detail.aspx?UBI=601300838&LIC=MSCON""099KA&SAW= 2/3 ., 1 ,: 8/9/2017 M S CONSTRUCTION 316581677 Location 2139 S G Street Tacoma,WA 98402 Inspection results date 12/07/2011 Violat, Inspection no. 315578542 Location 16715 36th Ave E Tacoma,WA 98446 Washington State Dept,of Labor&Industries.Use of this site is subject to the laws of the state of Washington. Help us improve https://secure.ini.wa.gov/verify/Detail.aspx?UBI=601300838&LIC=MSCON**099KA&SAW= 313 i i POLICY NUMBER:CBC20002096200 COMMERCIAL GENERAL LIABILITY CO DS 0110 01 COMMERCIAL GENERAL LIABILITY DECLARATIONS Endurance American Specialty Insurance Company TKG WHOLESALE BROKERAGE, INC. 3333 New Hyde Park Road, 2525 E Camelback Road,Suite 800 Suite 210 Phoenix AZ 85016 New Hyde Park NY 11042 NAMED INSURED: Michael Sweet /B/A NAME: M.S. Construction MAILING ADDRESS: 15625 264th St E Graham,WA 98338 DOLICY PERIOD: FROM 02-26-2017 TO 02-26-2018 AT 12:01 AM. TIME AT FOUR MAILING ADDRESS SHOWN ABOVE IN RETURN FOR THE PAYMENT OF THE PREMIUM,AND SUBJECT TO ALL THE TERMS OF THIS POLICY,WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. LIMITS OF INSURANCE EACH OCCURRENCE LIMIT $ 1,000,000 DAMAGE TO PREMISES RENTED TO YOU LIMIT $ 100,000 Any one premises MEDICAL EXPENSE LIMIT $ 5,000 Any one person DERSONAL&ADVERTISING INJURY LIMIT $ 1,000,000 Any one person or organization 3ENERAL AGGREGATE LIMIT $ 2.000,000 DRODUCTS/COMPLETED OPERATIONS $ AGGREGATE LIMIT $2,000,000 RETROACTIVE DATE CG 00 02 ONLY HIS INSURANCE DOES NOT APPLY TO"BODILY INJURY", 'PROPERTY DAMAGE"OR"PERSONAL AND ADVERTISING INJURY"WHICH OCCURS BEFORE THE RETROACTIVE DATE, IF ANY, SHOWN BELOW. RETROACTIVE DATE: None (ENTER DATE OR"NONE" IF NO RETROACTIVE DATE APPLIES) DESCRIPTION OF BUSINESS FORM OF BUSINESS. X INDIVIDUAL PARTNERSHIP DOINT VENTURE TRUST LI MITED LIABILITY COMPANY INCLUDING A CORPORATION (BUT NOT RRGANIZATION, CLUDING A PARTNERSHIP, JOINT VENTURE OR LIMITED ABILITY COMPANY) BUSINESS DESCRIPTION: contractor CG IDS 01 10 01 0 ISO Properties, Inc., 2000 Page 1 of 3 t7 ALL PREMISES YOU OWN RENT OR OCCUPY LOCATION NUMBER ADDRESS OF ALL PREMISES YOU OWN, RENT OR OCCUPY 1 15625 264th St E, Graham, WA 98338 CLASSIFICATION AND PREMIUM LOCATION CLASSIFICATION CODE PREMIUM RATE ADVANCE PREMIUM NUMBER NO. BASE Prem/ Prod/Comp Prem/ Prod/Comp O s O s OPS O s 1 -arpentry- 91340 114,800 18.094 24.254 $2,077 $2,784 ;onstruction of presidential property not exceeding three stories in height 1 contractors- 91585 15,000 7.392 N $111 N subcontracted work- n connection with ;onstruction, -econstruction, repair )r erection of )uildings Add'I Insured-Blanket E0007 1 (F) 500.000 $500.0 (Contractors) (Deductible Liability CG0300 1 (F) 149.000 $149.00 Insurance Designated CG2503 1 (F) N/C N/C onstruction Project(s) General Aggregate -imit Naiver of Subrogation- E0008 1 (F) 100.000 $100.0 31anket(Written contract) atop Gap-Employers CG0442 1 (F) 150.000 $150.0 Liability Coverage ndorsement- Nashington STATE TAX OR OTHER (if applicable) $ 126.92 TOTAL PREMIUM (SUBJECT TO AUDIT) $ PREMIUM SHOWN IS PAYABLE: AT INCEPTION $ 5,871.00 AT EACH ANNIVERSARY $ (IF POLICY PERIOD IS MORE THAN ONE YEAR AND PREMIUM IS PAID IN ANNUAL INSTALLMENTS) AUDIT PERIOD(IF APPLICABLE) X ANNUALLY �IEM I - DUARTERLY MONTHLY ANNUALLY ENDORSEMENTS NDORSEMENTS ATTACHED TO THIS POLICY: Page 2 of 3 0 ISO Properties, Inc., 2000 CG DS 0110 01 ❑ Department of Labor and Industries p STRUCTION PO Box 44450 r Olympia,WA 98504-4450 4�`ry'l CC SON**099KA ,p§0 - 60-8.38 �,ed aprovided by Law as: Gqg stW ion Contractor 'Al = F, IERAL ; " '` Date:: l.1/1991 M S CONSTRUCTION 15625 264TH ST E s F:, o.u on Rate:7/17/2019 GRAHAM WA 98338 k .�. •,�. is ter.rj7 •r •��;��,�fy, � ' 1 ,�� it •d��C�-a� �q��,� ( i D D Permit Information Date 7/24/2017 Permit Number 1563 Project Name Northern Grow,LLC Applicant Name Kenneth Gong Applicant Address 2617 98th Place SE City,State,Zip Everett,WA 98208 Contact Kenneth Gong Phone 26-295-8833 Email Permit Type Tenant Improvement Site Address 19320 63rd Ave NE Valuation 50000 00. Lilb. orl; .. Status Applied Permit Issued Permit Expires Square Feet 13895 Type of Construction/Occupancy Load Number of Stories 1 Proposed Use 1 502 Producer/Processor Assigned To Kristin Foster Property Information Owner Information Parcel#:31051500401200 CITY OF ARLINGTON CITY OF ARLINGTON 18204 59TH DRIVE NE 19320 63rd Avenue NE ARLINGTON,WA 98223 Review Date Type Description Target Date Completed Date Assigned To Status 7/26/2017 Commercial T.I. 8/2/2017 Rick Karns In Review 7/26/2017 Commercial T.I. 5/2/2017 PW Admin Rev In Review 7/26/2017 Commercial T.I. B/2/2017 PW-Sew-Rev In Review 7/26/2017 Commercial T.I. �5/2/2017 PW-Wat-Rev in Review Fees Fee Description Notes Amount Building Plan Review Feel 345.83.00.00 $592.66 Totall $592.6 Payments Date I Paid By Amount I Description Payment Type Accepted B 7/24/2017 IKenneth Gong $592.6 5650759 Total $592,661 Amount Outstanding $0.0 Uploaded Files Upload File Date File Uploaded B 7/26/2017 1.4&39 PM 1563_ Application.odf Foster,Kristin X 7/26/2017 1 A8:39 PM 1563 Plans.pdf Foster,Kristin x 7/26/2017 1 A8:39 PM 1563 Structurals.pdf Foster,Kristin j{ C1�Y U� 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 KTenant Improvement Project Address: J 93 ZG' (p p hlj F_ /0 /902-3 Parcel ID#: Project Description: ��NU��'1/r /� J>�/� j F,7z. Oeal ? Legal Description: Project Valuation: Owner: / 77 .e/� ��dGCJ C Phone Number: Address: r,� /� City: State: Zip Code: ? Contact Person: AIF- 7- CzlN4!�— Phone Number: ?1___1__ cqo 33 Cell Phone: E-mail: Address: 2-61 7 00fo OPL $;P— City: �/,�/L;�T] State:I.L)/I'- Zip Code: { e oae, Contractor: t 7 \/ Clr. Phone Number: Address: City: State: Zip Code: Contractor's License Number: Expiration: 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 JUL 2 4 2017 ?- �b (s�3 REV 2015 Page 6 of 7 _k� " . Y O� 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 ,yew T g-ge-/J 6�' g) Z(,C Site Address ��7 0 l��'eDU R, Bldg./Unit/Suite IBC Construction Type Ir' �lV&(-�M%P )IBC Occupancy Type F- 1 Description of Use &ggW C'��r/)'T7er') ( Piz 0PLe�tz Building Square Footage 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 Washingtontyl::7� Applicants Signature Print Applicants Name Date FOR STAFF USE ONLY 1�1�3 [JUL 2 4 2ot7 Permit# Accepted By Amount Received Receipt# Date Received REV 2015 Page 7 of 7 DocuSign.�-nvelopeID: 139A1FC3-07D1-42BD-A54? "ti�3544AE022 s1AnrE State of Washington mill°� WRA�mWWII 111 � ^ Business Licensing Service o^ g PO Box 9034 Olympia WA 98507-9034 For Validation-ice Use Only oyp Telephone:I-800-451-7985 business.wa.gov/BLS Business License Application For faster service apply online at buslness.wa.govBLS Northern Grow,LLC Online applications are typically processed within ten business days. Legal Enflty/Owner Name It may take up to six weeks if you file by mail. 604-048-059 Unified Business Idenlifler(UBI) 1. Purpose of Application Fe2-124deral pl6jrer8ldentlflcatlonNumber(FEIN) Please check all boxes that apply. ❑ Open/Reopen Business ❑ Add Endorsement/Registration to Existing Location complete sections 2,3,4, (5 if hiring employees)and 6 complete sections 2,3,4,and 6 ❑ Open Additional Location ❑ Business Has or Will Have Employees complete sections 2,3,4, (5 ff hiring employees)and 6 complete all sections ❑ Change Ownership ❑ Business Has or Will Have Employees Under Age 18 complete sections 2,3,4, (5 if you have employees)and 6 complete all sections(If this business location has an active Workers' Compensation account with L&I,and there were no ❑ Register Trade Name --"-' Business License Application complete sections 2,3,4 and 6 s 2,3a,3c,3d,[and 3f for sole ❑ Change Trade Name-complete sections. Name(s)to be cancelled: round Your Home ® Change Location-complete sections 2,3, Old address to be closed: 28 Horizon F 2. Endorsements and Fees Use the Endorsement Fee Sheet for the inforrT Mark Registrations Needed: Fees Due ❑ Tax Registration(State Dept.of Revenue)— Yes ❑ No No Fee ❑ Industrial Insurance(Workers'Compensati No Fee ❑ Unemployment Insurance—Required it No Fee ❑ Minor Work Permit—Required if you will No Fee ❑ New Trade Name(Doing Business As): $5.00 List Additional Trade Names ($5 each name)or Other Endorsements (such as Lottery Retailer): ➢ Marijuana Change of Location s 75.00 v 'r Enclose check for total amount due,including the non-refundable Processing Fee,which MUST be submitted with this form. Processing Fee 19.00 Make check payable to the Department of Revenue. Total Amount Due $ 94.00 To receive this document in an alternate format,please call 1-800-647-7706.Teletype(TTY)users may use the Washington Relay Service by calling 711. BLS-70D-M(11/16116)PAGE 1 OF 4 DocuSign Envelope ID: 139A1FC3-07D1-42B' i43-2013544AE022 3. Owner Information _ r a.*Select only ONE ownership structure: ❑ Sole Proprietorship If married,should spouse's name appear on license? ❑Yes ❑No(if you answer No,you must still enter the spouse information in section`Y"below.) d ❑ Corporation* ❑ Non Profit Corporation* � p p (educational,religious,charitable) Limited Liability Company* ❑ Partnership (#of partners: ) ❑ Joint Venture 2 ❑ Limited Partnership* ❑ Limited Liability Partnership* ❑ Limited Liability Limited Partnership* rn 'These ownership structures must contact the Secretary of State office for additional filing requirements. t Northern Grow,LLC Name of Corporation,LLC,Partnership,LLP,LLLP,or Joint venture Name(examples:ABC,Inc. OR Fir Trees Unlimited LLC) o State incorporatedff Washington ormed: _ ❑ Year incorporated/formed:2016 ❑ Association ❑ Trust ❑ Municipality ❑ Tribal Government Other Name of Organization(example:Anderson Family Trust) b.*Business Open Date 04 46 /17 Provide the ownership structure's first date of business at this location. Out-of-state businesses should MM DO YY use the first date of operation in WA. (Required.If unknown,please estimate.) C. Northern Grow Is this location inside city limits? 19 Yes ❑ No *Business Namertrade Name d, 18415 Occidental Ave S 19320 63rd Ave NE *Business Malling Address(Street or PO Bar,Suite No.do not use bulllding name) Business Street Address(It dtlferent than mailing)Do not use PO Box or PMB Burien WA 98148 Arlington WA 98223 city State Zip code City State Zip code e. (206 ) 805-9724 ( ) woohong@gmailcom Business Telephone Number Fax Number E-Mall Address f. Ust all owners&spouses: Sole proprietor,partners,officers or LLC members. (Attach additional pages if needed.) Woo,Hong 534-92-6354 03126 /73 *Name(Last,First Middle) Social Security Number` Date of Birth %Owned' 18415 Occidental Ave S Burien WA 98148 Home Address(Street or PO Box) city State Zip code Member 006 )805-9724 Are you married? ❑ Yes:6 No It yes,enter spouse Information below. Title Home Telephone Number" Spouse Name(Last,First,Middle) Spouse Social Security Number Spouse Date of Birth y,Chan,Richmond 537-90-5069 05 /11 1,76 00 Name(Last,First Middle) Social Security Number' Date of Birth %Owned' a 318 Powell Ave SW Renton WA_ 98057 rn Home Address(Street or PO Box) city State Zip code ` Member (206 ) 778-0220 c Are you married? ❑Yes ® No If yes,enter spouse information below. Title Home Telephone Number' 0 / Spouse Name(Last,First,Middle) Spouse Social Security Number Spouse Date of Birth Gong,Kenneth 535-88-2419 01 101 /73 Name(Last First,Middle) Social Security Number" Date of Birth %Owned' 2019 NE 33rd PL _ Renton _ WA 90856 Home Address(Street or PO Box) City State Zip code Member (206 ) 295-8833 Are you married? X Yes ❑ No If yes,enter spouse information below. Title Home Telephone Number' Gong,Wa Ping,lau 533-39-8997 11 122 /76 Spouse Name(Last,First,Middle) Spouse Social Security Number Spouse Date of Birth "The Social Security Number is required for sole proprietors,partners,officers,and LLC members of businesses that will have employees. (WAC 192-310-010) Not fully completing section'Y"will result in application delays. BLS-700-028(11/16/16)PAGE 2 OF 4 DocuSign Vnvelope ID:139A1FC3-07D1-42BD-A543 3544AE022 DoauSlgn Envelope ID:2DE5F779-D7F8-4738-AC50-B692DD132EA3 Addis-il 0 �'. �v,nea, 1,Jifl , aZIOq /1OPI 53I - l3- 574Y3 2-S2q 5 Edd Sk. 5CQ +�e./ WA 9 9109 ao� ffwrie� V c4Z5'—(023- '717cj DocuSign Envelope ID:139A1FC3-07D1-42B' i43-2013544AE022 4. Location / Business Information a. Are you an out-of-state business with no Washington location and have employees or representatives working in Washington? ❑Yes 9 No If yes,provide one of their Washington addresses(we will not use this address for mailing purposes): Business Street Address(Do not use a PO Box or PMB Address) city State Zip code b. Do you plan to hire independent contractors or people you will report on a 1099 form? ❑ Yes ® No Check"Independent Contractors°definition at www.lni.wa.gov/IPUB/101-063-000.pdf C.*Provide the estimated gross annual income in Washington (check the one box that applies to your business): ❑ $0-$12,000 ❑ $12,001 -$28,000 ❑ $28,001 -$60,000 ❑ $60,001 -$100,000 ® $100,001 and above d. Mark the business activities in Washington State(check all that apply): ❑ Wholesale ❑ Retail 0 Manufacturing ❑ Services e.*Describe in detail the principal products or services you provide in Washington State: Licensing marijuana production and proccessing f. Did you buy,lease,or acquire all or part of an existing business? Yes ❑ No Date boughtAeased/acquired: 10 119 12016 Methow Valley Nursery MM DD YY Prior Buslness Name Edward Rhinehart (425 ) 248-0994 Prior Owner's Name Telephone Number g. Did you purchase/lease any fixtures or equipment on which you have not paid sales or use tax? ❑ Yes 1b No If yes, indicate purchase or lease price: $ h. If this business is owned by,controlled I*or affiliated with any other business entity,provide that business en*/s name and UBI number: Entity Name UBI Number Entity Name UBI Number I. If you are changing your business structure(such as changing from sole proprietorship to corporation)and want the old account closed,provide the UBI number to be closed: Do you wish to cancel all the trade names registered under the old UBI number? ❑ Yes in No You must re-register all trade names you use under the new business structure. j. If you have ever owned another business,provide: Business Name UBI Number k. Provide your bank's name: NIA Branch: NIA If you plan to have employees or wish to register for elective coverage for owners or excluded employees,complete Section 5. (For information see the Industrial Insurance or Unemployment Insurance sections on the Endorsement Fee Sheet.) OLS-700-028(11116116)PAGE 3 OF 4 DocuSign Envelope ID:139A1FC3-07131-42BD-A54? -'13544AE022 1 5. Employment/ Elective Coverage Employment accounts cannot be established unless you plan to employ persons within the next 90 days. If accounts are established,employment tax returns will be required quarterly even if you have not hired. a. *Date of first employment or planned employment at this location: 08 /01 /17 First date wages paid: 08 101 /17 MM DID YY MM DID YY b. Number of persons you employ or plan to employ at this location(do not include owners): C. *Estimate the number of persons under age 18(minors)you will employ in the next 12 months and duties they will perform: Number Duties to be performed by minors(Check www.teenworkers.lni.wa.gov) Ages 16-17: 0 Ages 14-15: 0 Under age 14. 0 d.Check the ONE box which best describes the major operation of your business. ❑(01)Drywall Operations ❑(05)Maritime/Vessels/Longshore ❑(09)VehicleSvcs/Transportatfon❑(13)RetaiVWhlsl:Stores&Warehsing ❑(02)Logging/Forestry ❑(06)Electronics/Utilities/Vending Mch ❑(10)Mfg-Chem/Textiles/Paper ❑(14)Food Svcs/Chore/Asst Lvg/Janitor ❑(03)ConstructiorVEngrg/Property Mgmt❑(07)Wood Prod/Stone/Glass&Mining ❑(11)Mfg-Food/lce;3everages ❑(15)Medla/Entertainment/Lodging ❑(04)Temp Help Co/Employee Leasing ❑(08)Mfg-Metal/Mach Shops/Millwright ❑(12)Agriculture/Farming ❑(16)I.T./Prof Svcs/Med/Salon/Schools e. Describe in detail the activities of your workers.Then estimate the total workers' 3-Month Estimate hours for a 3-month period.(One full-time worker=480 total hours for 3 months.) Number of Workers'Hours Workers (Include Minors Example: Office Staff-reception,accounting, data entry 2 960 i f. If you have more than one Washington location, how do you wish to receive the following quarterly reports? Unemployment Insurance: ❑All locations combined ❑ Each location separately(multiple reports) Workers'Compensation: ❑All locations combined ❑ Each location separately(multiple reports) Additional Coverage is available as noted below.(See Endorsement Fee Sheet for more information.) g. If you are a profit corporation, do you want unemployment insurance coverage for corporate officers? ❑Yes-Go to esd.wa.gov to obtain a Voluntary Election form.This form is required for coverage. 14 No-The corporation must inform officers in writing that they are not covered for Unemployment Insurance. h. Do you want workers'compensation coverage for owners(sole proprietor,partners,corporate officers,LLC members/ managers)?(In an LLC with managers,you may elect to cover those persons who are both members(owners)and managers. In an LLC with members only,you may elect to cover those members.) ❑Yes-Prior to coverage,Form F213-042-000 is required.This form will be sent to you by the Dept.of Labor&Industries. Z No I. Do you want elective workers'compensation coverage for excluded employment? (See Endorsement Fee Sheet for descriptions.) ❑Yes- Prior to coverage, Form F213-112-000 is required.This form will be sent to you by the Dept.of Labor&Industries. 14 No 6. Signature Signature of sole proprietor or spouse,partner,corporate officer,or limited liability member/manager. I,the undersigned,declare under the penalties of perjury and/or the revocation of any license granted,that I am the applicant or authorized representative of the firm making this application and that the answers contained,including any accompanying information,have been examined by me and that the matters and things set forth are true,correct and complete. ftowl May 15 2017 *SigU1ao nature Re uired Date Christopher Lynch Attorney (206 )355-5527 04 119 12017 Application Prepared By(Please Print) Title Telephone No. Date Some agencies can provide language assistance. Would you like assistance? ❑Yes IM No Specify language _ BLS-700-028(11/16/16)PAGE 4OF 4 DocuSign Envelope ID: 139A1FC3-07D1-42B' ,43-2013544AE022 w 3.A State of Washington Business Licensing Service PO Box 9034 Olympia,WA 98507-9034 1-800-451-7985 Endorsement Fee Sheet Use the Business License Application to obtain any of the endorsements listed on this form. We have indicated which endorsements you can apply for using our online application. To apply for endorsements not available online please fill out the required forms and send them by mail. We have also indicated if an endorsement requires agency approval.Do not begin an activity requiring approval until you receive a Business License that displays the name of that endorsement. There are many other endorsements not available through the Business Licensing Service. To determine if you need any others,or to download application forms,visit our Business Licensing Guide at business.wa.gov/BLS or call us at 1-800-451-7985. Application Fee • Entertainers and musicians. $19-non-refundable fee 0 Volunteer law enforcement officers. Department of Revenue Must be paid each time a Business License Application Is Volunteer workers or student volunteers(K-12). submitted. • Community service workers. The following endorsements are valid as long as you • Cosmetologists,barbers,estheticians or manicurists who remain in business. lease stations. Tax Registration Newspaper carriers and freelance journalists. No additional fee 0 Insurance agents,brokers and solicitors. Department of Revenue You must obtain a tax registration if you answer"yes"to any Unemployment Insurance of the questions listed below.A tax registration cannot be No additional fee transferred to another business. Employment Security Department • Do you plan to gross over$12,000 per year? If you employ one or more people,you must apply for unemployment insurance coverage.Social Security numbers • Will you be selling at retail any item or product to another are required for all owners of a business that hires employees. person? All corporate officer wages of profit corporations are exempt • Will you be repairing,installing,altering,decorating,or from UI Taxes in Washington.However a corporation may elect improving any item or product for another person(e.g.,car to pay taxes on all officer wages by completing the Voluntary repair,construction)? Election Form with the Employment Security Department • Will you engage in a business that is responsible for any and choosing voluntary coverage on the Business License other state taxes(e.g.,timber,fish, litter,public utility, Application. hazardous substance/waste,etc.)? Non profit 501(c)(3)corporations must report and pay taxes on Industrial Insurance officer wages. No additional fee Trade Name(s) Department of Labor&Industries $5 per name If you employ one or more people,you must apply for industrial Department of Revenue insurance coverage.Excluded Groups:The groups listed Trade Name or"Doing Business As"name must be registered below are excluded from mandatory coverage,but you may if: request optional coverage by completing the Employment section of the Business License Application.An Application Sole proprietor or partnership is using a name other than for Optional Coverage will be sent to you.Excluded groups the full legal name of all the owners;or include: 0 Corporations, limited partnerships or limited liability • Sole proprietors,partners,LLC members with companies are operating under a name other than the management responsibility. name registered with the Office of the Secretary of State. • Executive officers and corporate officers who are directors Please Indicate all"Doing Business As"names on Section 2 of and shareholders.If you select elective coverage for your the Business License Application. executive officers,all executive officers must be covered. • Domestic servants(if less than 2 full time employed)and This registration does not provide protection of the name.To those performing gardening,maintenance or repair around see if the Trade Name you are planning to use is already the private home. registered,visit the Business Licensing Service website at: • Services in return for aid or sustenance received from a www.bls.dor.wa.gov/licensesearch/ religious or charitable organization. Please contact the Business Licensing Service at • Minors under 18 employed on the family farm. 1-800-451-7985 for more information. • Jockey racing. BLS-700-Ml(12/20/18)PAGE 1 OF 6 DocuSign(Envelope ID: 139A1 FC3-07D1-42BD-A54^-I 3544AE022 enewable Endorsements a combined total of$250.00 will be due for both Must be renewed annually endorsements) Architect Firm Tobacco Products Distributor Certificate of Authorization Main location $650 $100 main location Each branch location $115 Additional forms required Purchase,sell, or distribute tobacco products Department of Licensing other than cigarettes to retailers for resale. Required for businesses practicing or offering to practice (Fee waived if also applying for, or architectural services in Washington. Each firm is required already have,Cigarette Wholesaler.) to have at least one Designated Architect listed at the licensed location. The Designated Architect must have an Collection Agency active architect registration. $850 for main location in Washington $550 for each branch location(in Washington or out of Bulk Fertilizer Distributor state/country) $25 per location Additional forms and agency approval required Department of Agriculture Department of Licensing Required for any business that brings into or that distributes Required for any Washington business that: within Washington commercial fertilizer in bulk(nonpackaged 0 Directly or indirectly collects debts on behalf of clients form). located in Washington and/or other states; Cigaretterrobacco Sales,Retail and Wholesale 0 Solicits claims for collection; Liquor and Cannabis Board 0 Markets forms or a collection system to be used in debt The cigarette and tobacco product endorsements must both collection;or be held if cigarette and other tobacco products are sold Collects their own debts using a fictitious name to imply at the same location.Additional documents and agency that a third party is involved;or approval required. Cigarettes Purchases claims for collection purposes in Washington, whether or not it collects the claim itself. Cigarette Retailer $175 The business must maintain a trust account and an office in Cigarettes sold at retail.Fee required per Washington for the purpose of conducting its collection agency location.(If BOTH a Cigarette Retailer OR an Other business.The office must be managed by a Washington Tobacco Product Retailer AND a Vapor Product resident and be open to the public during regular business Retailer are applied for at the same time,for the same hours.A$5,000 surety bond is required. business location, a combined total of$250.00 will be due for both endorsements) Collection Agency—Out-of-State/Country Commercial Cigarette Making Machine $93 $425 for main out-of-state location Required where a machine to produce`Roll Your $275 for each branch location(out-of-state/country) Own'cigarettes is provided.The fee is required for Additional forms and agency approval required each location with one or more machines.A Cigarette Department of Licensing Retailer endorsement and Tobacco Products Retailer Required for any business outside Washington that; endorsement is also required. The machine can only Undertakes the collection of a debt on behalf of clients be used with tobacco sold at the location at the time of who are also outside Washington,and that uses only purchase. telephone,mail or fax to collect,or attempt to collect, Cigarette Vending Machine on debts from persons or businesses located inside $30 per machine at each location Washington.A$5,000 surety bond is required;or A Cigarette Retailer endorsement is also required. Purchases claims for collection purposes in Washington, Fee required per machine at each location. whether or not it collects the claim itself. Cigarette Wholesaler Note:Based on other states'laws,some businesses may be Main location $650 exempt from these endorsement fees and bonding.Please Each branch location $115 contact the Business&Professions Division at(360)664-1388 Purchase,sell,or distribute cigarettes to for more information. retailers for resale.You must include with your application the$5,000 surety bond Commercial Telephone Solicitor required by the Department of Revenue. $72 per location Tobacco Products Additional forms and agency approval required Department of Licensing Tobacco Products Retailer $175 Required for each location making unsolicited commercial Retail sales of tobacco products other telephone calls and selling goods or products during the call. than cigarettes.Fee required per location. Also required for those who offer free prizes by mail and invite (Fee waived if also applying for, or already have, a telephone response.Exclusions from coverage include,but Cigarette Retailer at same business location.if BOTH are not limited to,those soliciting for educational,political,or a Cigarette Retailer OR an Other Tobacco Product charitable purposes;those for whom less than 60 percent of Retailer AND a Vapor Product Retailer are applied the prior year's sales were made by telephone solicitations; for at the same time,for the same business location, and those who sell to businesses who either resell the product or use it for manufacturing. For tax assistance or to request this document in an alternate format,please call 1-800.451-7985.Teletype(TTY)users may use the Washington Relay Service by calling 711. BLS-700-031(12/20/16)PAGE 2 OF 6 DocuSign Envelope ID:139A1FC3-07D1-42Br 43-2013544AE022 Contractor Registration however all vehicles must have a for hire certificate from the Additional forms required state, regardless.See also the section headed"Weighing& Registration not available through BLS Measuring Devices" about registering the meter used in for Contact: Dept.of Labor&Industries(360)902-6359 or hire vehicles. 1-800-647-0982(in state only)or www.Ini.wa.gov Any individual or business involved in construction, Limousine Carrier remodeling, repair,excavation,or demolition of any structure, $350 per location road or property must obtain a Contractor Registration.This Vehicle Certificate:$75 per limousine includes those who install floor coverings,lawn sprinkler Vehicle Inspection Report:$25 per limousine systems,or scaffolding.Those who perform plumbing or Additional forms and agency approval required electrical work must have additional certifications or licenses. Department of Licensing, Washington State Patrol,and Registration is also required for an individual who plans to hire Port Districts of King County subcontractors from more than one trade to work on a single Required for any business that operates unmetered, project related to the individual's own property,with the intent unmarked,chauffeur-driven, luxury,for hire vehicles to sell that improved property. (definition of a limousine is found in RCW 46.04). Limousines must transport persons under a single Corporate Registration contract,on a prearranged basis,to a specific destination Additional forms required or particular itinerary.Each limousine vehicle must pass Registration not available through BLS a vehicle inspection and be certified by the Department Contact:Office of the Secretary of State(360)725-0377 of Licensing.Businesses operating in the Port District of Washington based corporations doing business in Washington King County may be licensed through the port district. must file Articles of Incorporation. Other for hire businesses(such as taxi cabs)must register Firms incorporated in any other state or country should contact separately with the Department of Licensing (see For Hire the Corporations Division of the Office of the Secretary of license). State for filing requirements.in addition to filing the corporate Liquor registration forms a Business License Application is required Variable fees(see Liquor License Description and Fee to BLS. Information Sheet) For expedited service to incorporate your business,complete Additional forms and agency approval required the Application to Form a Profit Corporation at www.secstate. Liquor and Cannabis Board wa.gov/corps Required for businesses or nonprofit organizations retailing Or you can complete the application on paper and mail it in a or serving beer,wine or spirits;or manufacturing, distilling, separate envelope to: wholesaling,transporting, importing, or exporting alcoholic Corporations Division beverages.Also needed for changing the location of a Office of the Secretary of State licensed premises. PO Box 40234 Olympia,WA 98504-0234 Lottery Retailer $25 per location(one-time,nonrefundable) Egg Handier/Dealer Additional forms and agency approval required. $30 for first location Washington's Lottery $15 for each additional location Required for businesses selling Lottery products.Applicants Additional forms required must certify that they comply with federal,state and agency Department of Agriculture accessibility requirements,and provide a personalicriminal Required for businesses or persons that: history.The Lottery also requires an electronic funds transfer account to transfer Lottery sales debits and credits. • Produce, handle,contract for,or obtain possession or The Lottery will separately charge retailers a one-time control of eggs for sale to wholesalers,dealers or retailers $200 set-up fee,and a weekly equipment and support fee. within or into Washington;or Contact the Lottery at 1-800-732-5101,option 4,for more • Process eggs and sell them to wholesalers,dealers, information. retailers or consumers within or into Washington. A license must be posted at each location where the licensee Mobile to me Pa bile Home Community operates.Note: Poultry producers who sell eggs from their (Mobile Home Parks) * Ad own flocks at the place of production directly to household per qualifying manufactured home in park consumers do not need to be licensed. Additional forms required Department of Revenue For Hire Required of all manufactured and mobile home parks that Permit:$110(one-time,nonrefundable) offer two or more spaces (lots) in the park for rent or lease Certificates:$55 per vehicle for year-round occupancy.A separate application must be Additional forms and agency approval required submitted for each park.New parks must be registered Department of Licensing within three months of offering spaces for rent to avoid Required for all vehicles used for the transportation of penalties. passengers for compensation in taxicabs, cabulances or *A$10 fee must be paid for each manufactured or mobile other for hire vehicles(except limousines see Limousine home within the park when the owner of the home does not Carrier for those for hire vehicles).The state permit fee is also own the space on which the home is located. not required if a permit fee is paid to a local city or county, BLS-700-031(1220116)PAGE 3 OF 6 Docu Sign.Envelope ID:139A1FC3-07D1-42BD-A54--'\13544AE022 1 Marijuana or reveal criminal activity;obtain information related to Additional forms and agency approval required persons or things;recover lost property;identify cause Liquor and Cannabis Board for accidents/losses;obtain evidence for investigations or Marijuana Transportation-Available online $2� detect eavesdropping devices.See RCW Chapter 18.165 p for full description. Required for transport businesses to transport or deliver marijuana, marijuana concentrates,or marijuana-infused Radiology Benefit Manager products between licensed marijuana businesses within $200 per location Washington State. Additional forms required Note:The Liquor and Cannabis Board will contact Department of Licensing applicants for any additional required information or Required for any person or company conducting business documentation,and bill for the initial license fee prior to in Washington or with Washington customers when the approval of any license. business is owned by a third parry payor or a carrier, as Minor Work Permit defined in RCW 48.43.005,or contracts with a third party No fee payor or carrier in order to: Agency approval required • Process claims for services and procedures performed Department of Labor and Industries by a licensed radiologist or advanced diagnostic If you employ one or more people under 18 years old,you imaging service provider. must apply for a permit to employ minors,in addition to • Pay or authorize payment to radiology clinics, industrial insurance as described on page 1. radiologists,or advanced diagnostic imaging services Nursery Retailer/Wholesaler providers for services or procedures. Fees listed below Include a 20%surcharge Rental Car Registration Additional forms required No fee Department of Agriculture Department of Licensing Required for businesses that: A rental car is a passenger vehicle(PAS or M/H use class) • Sell or hold live plants or turf for planting,breeding, or that is used solely by a rental car business for rental to decoration;or others,without a driver provided by the rental car business, Perform landscaping and lawn maintenance which for periods of not more than 30 consecutive days.Only passenger vehicles (cars,SUVs and motor home qualify). provides planting or installing new plants or turf. Trucks and other types of vehicles such as motorcycles are Is not required if you sell less than$100 per year or only exempt from the rental car registration. sell cut flowers. Choose either a wholesale or retail endorsement based Scrap Metal on what you believe will be your primary source of income, Various Fees (see the Vehicle-Related and Scrap Metal then estimate your total nursery sales for the calendar year. Recycling Fee Description Sheet) Determine the fee due based on your license type and your Additional forms and agency approval required. sales estimate. Department of Licensing Required for businesses that are suppliers, processors, Nursery Retailer: Fee: and/or recyclers of scrap metal. $100-$2,499 $63.00 per location Note: These endorsements do NOT include handling scrap $2,500-$14,999 $138.00 per location metal from motor vehicles.For vehicle-related Motor Vehicle $15,000 and over $273.60 per location Salvage processing see the entry under"Vehicle Sales or Disposal'. Nursery Wholesaler: Fee: $100-$14,999 $138.00 per location $12Seed Dealer $15,000 and over $273.60 per location Department per location Department of Agriculture Required for selling seeds except those packaged in Pesticide Dealer containers of 8 ounces or less by a registered seed labeler. $67 per location Additional forms and agency approval required Seller of Travel Department of Agriculture $202 per location Required to sell all pesticides.Exception: Not required if Additional documents and agency approval required the pesticide is labeled home and garden use only.Each Department of Licensing location must have a licensed Pesticide Dealer Manager to Required for businesses that arrange,or advertise to supervise pesticide distribution. arrange travel accommodations for Washington consumers. Private Investigative Agency Shopkeeper $600 with unarmed principal $40 per location $700 with armed principal Department of Health—Board of Pharmacy No fee for each additional location Required of businesses(except licensed pharmacies) Additional forms and agency approval required selling any nonprescription medication.These medications Department of Licensing must be in the original manufacturer's packaging. Required for any business that exists to detect, discover BLS-70U31(1=0116)PAGE 4 OF 6 DocuSign Envelope ID: 139A1FC3-07D1-42Br 13-2013544AE022 Tobbaco Sales,Retail and Wholesale- • Transport vehicles over Washington highways; Please see Cigarette/Tobacco Sales • Operate a registered tow truck;and/or Underground Storage Tanks • Act as a hulk hauler,vehicle wrecker or motor vehicle $160 per tank salvage processor.Note: This is NOT for non-vehicle Additional forms required scrap metal.To handle non-vehicle scrap metal see the Department of Ecology entry under"Scrap Metal". Required for owners of storage tanks with a capacity greater than 110 gallons,that have at least 10 percent of Waste Tire Carrier volume(including piping) below the surface of the ground, $200($50 nonrefundable)plus$50 per vehicle and that contain petroleum or other hazardous substances. Additional forms and agency approval required Some tanks may be exempt.The application must be Department of Ecology filed by the owner within 30 days after a new installation Required for businesses transporting tires no longer usable is complete, or upon modification or purchase of existing due to wear,damage or defect.Businesses licensed by tanks.Note:A notice of intent to install (Form ECY 020-95) the Utilities and Transportation Commission or a local must also be filed directly with the Department of Ecology government authority need not apply.A$10,000 bond is at least 30 days before new installation work begins. required. Vapor Product Retailer $175 Waste Tire Storage Site Owner Required for each location of a business where vapor $250 per location($50 nonrefundable) products are sold at retail to consumers.(If BOTH a Additional forms and agency approval required Cigarette Retailer OR an Other Tobacco Product Retailer Department of Ecology AND a Vapor Product Retailer are applied for at the same Required of any business with outside storage of more time,for the same business location,a combined total of than 800 tires which are no longer suitable for their original $250.00 will be due for both endorsements)Note:To sell purpose.The business is required to have: at retail cigarettes and other tobacco products,a Cigarette . A permit from the County Health Department where the Retailer or a Tobacco Products Retailer endorsement is site is located. also required. • Financial assurance sufficient for hiring a third party Vapor Product Distributor $150 to remove the maximum number of tires permitted to be stored at the facility and deliver the tires to a facility Vapor Product Distributor Branch $100 permitted to accept the tires. Required for each location of a business that purchases Contact Dept.of Health for regulatory questions at 1-800- vapor products and conducts wholesale sales or distribution 299-9729. to vapor product retailers for resale to consumers.Note:To sell or distribute at wholesale cigarettes or other tobacco Weighing and Measuring Devices products you'll also need a Cigarette Wholesaler or a Various fees(see the Weighing and Measuring Devices Tobacco Products Distributor endorsement. Addendum) Department of Agriculture(statewide);and Cities of Seattle Vapor Product Delivery Sales $250 &Spokane Required for each location of a business, regardless Required for businesses where devices are used to whether located inside or outside Washington,from which determine the charges for a product or service on the basis retail sales orders for vapor products are taken from of weight or measure (i.e.scales or meters).The Weighing Washington consumers by means of telephone or other and Measuring Devices addendum must be submitted with voice transmissions, by mail or other delivery services,or the Business License Application. the Internet or other online services;or from which vapor products are delivered to Washington consumers by use of Whitewater River Outfitter the mails or other delivery services. $25 per location Additional form and agency approval required Vehicle Sales or Disposal Department of Licensing Various fees (see the Vehicle-Related and Scrap Metal Required for businesses carrying,or advertising to carry, Recycling Fee Description Sheet) for-hire passengers on whitewater sections of Washington Additional forms and agency approval required rivers.Applicants must provide proof of correct liability Department of Licensing insurance and certify that they meet all requirements, Required for businesses that: including use of qualified guides. • Annually offer, display or sell more than four cars, X-Ray Facilities and Devices trucks and/or motor homes,or otherwise act as a Various fees(see the X-ray Facility and Devices dealer of such vehicles; Registration Addendum) • Deal in boats or vessels, manufactured homes, park Department of Health(statewide) homes,travel trailers,fifth wheel trailers,horse trailers, Required for businesses that have a facility with any of utility trailers,off-road vehicles,motorcycles and/or the X-ray tube types listed on the x-ray addendum form, snowmobiles; including dental or medical offices, hospitals, veterinary, • Manufacture or remanufacture vehicles for distribution educational,security, research or industrial facilities. to Washington dealerships; Contact Dept.of Health for regulatory questions at 1-800- 299-9729. BLS700-031(1=0116)PAGE 5 OF 6 DocuSign Envelope ID:139A1FC3-07D1-421313-A54?^113544AE022 Business Licensing Service City Partners -Available online Most cities require businesses operating within the city limits to register and renew annually.This includes businesses that are located outside the city limits but perform services inside city limits. Apply for the cities listed below by using the Business License Application.See the City Fee Sheet for fees and descriptions. Some cities may have other requirements to conduct particular business activities such as a home occupation permit or temporary license.Contact the city directly for more information.City approval and additional forms may be required. Anacortes Longview Bellingham Maple Valley Blaine Marysville Bonney Lake Millwood Bridgeport Milton Buckley Monroe Carbonado Newcastle Carnation North Bend Clyde Hill Olympia Connell Port Orchard College Place Port Townsend Covington Poulsbo Deer Park Prosser DuPont Pullman Duvall Richland Eatonvil le Rockford Edgewood Ruston Enumclaw Sammamish Ephrata Sedro Woolley Fife Sequim Fircrest Shoreline Gig Harbor Skykomish Gold Bar Spokane Granite Falls Spokane Valley Ilwaco Stanwood Issaquah Sultan Kenmore Sumner Kennewick Tumwater Lacey University Place Lake Stevens Vancouver Leavenworth Washougal Liberty Lake West Richland Long Beach Woodinville Additional cities continue to partner with the Business Licensing Service program. Visit our webslte at http://business.wa.gov/BLS or contact us at 1-800-451-7985 for a current listing. BLS-700-031(12/20/16)PAGE 6 OF 6 � 51 k �91g�,� vrn��• S �� T-e,Ve-v- C L q �36a) 6�3 —�161s i ROOM 91-22BS SF ROOM i12-1,87D SF ROOM 0.1.B SF ROOM N-2,IWSF . .. - t 11T rN✓•c U•al rri a,c VOT QUAR •,f AREA TINE 1`JN_1 AREA EXTERIORYARD f \) 1Y'R,N4 ROOM 116-1,2655F ROOM 95-1,000 SF IOApa1GM110AODq HVAC UNIT HVAC UNIT S � � EXIST.LOBBY EXIST FENCE AND GATE �qL,V pp� ENTRY PROPOSED GROW ROOMS PRELIMINARY PLAN#1 NORTH ROOM#1 2,285 SF NTS ROOM#2 1,870 SF PROJECT LOCATION:19320 63rd AVE NE. ROOM#3 1,480 SF ARLINGTON WA 98223 ROOM#4 2,100 SF PARCEL M 31051500401200 ROOM#5 1,000 SF ROOM#6 1,265 SF 10,000 SF EXISTING BUILDING 13,895±SF EXISTING EXTERIOR YARD 4,906±SF L) V Brian Renninger Engineer E-mail 13 rl'a n R(,)j I-,)sc �i n a i r-ol`9 Direct 206-(_Aj9.407 / Toll Free 8 0 0.`)5 2,-3)-5 65 x Cell c e a n a 0 9 p s I d A puget Sound Clean Air Agency ('-1 :�� Peter Chopelas, PE Engineering &Design Services 307 North Olympic Ave, Suite#208 Arlington, WA 98223 (360) 653-4615 Chopelasandassociates@gmail.com July 24,2017 Kenny Gong, 206-295-8833 Northern Grow LLC, 18415 Occidental Ave S Burien,WA 98148 Subject:Conversion and alterations to existing commercial building for indoor growing production at 19320 63rd Ave NE, Arlington WA The lateral and vertical loads were analyzed for the changes to building according to the requirements of the 2015 International Building Code(ASCE 7-10). Note; the structural provisions of the 2015 IBC has not changed from the 2012 IBC. The following design conditions for the analysis are based on the site conditions or according to the minimum code requirements: Soil Bearing Capacity: 2,000 Lbs per SF. Ceiling live load: 25 PSF Floor load(slabe-on-grade) 125 PSF Wind Exposure/Importance: no wind exposure to internal changes Seismic Site Class: D, Sds =0.763 The shear loads on the internal walls and structure are due to seismic loading. All the stouter shown on the plans are more than adequate to brace the integral grow room structures. If you have any questions or are in need of further assistance please feel free to call. iN- COPI Lh. Received JUL 24 2017 Peter Chopelas PE NQ 111j� �? a f 4 C Design Maps Summary Report https://earthquake.usgs.gov/cnl/desigiunaps/us/sunumry.php?template... aMSGS Design Maps Summary Report User-Specified Input Report Title Norther Grow tenet improvments Thu July 20, 2017 23:49:36 UTC Building Code Reference Document 2012/2015International Building Code (which utilizes USGS hazard data available In 2008) Site Coordinates 48.17170N, 122.14657°W Site Soil Classification Site Class D -"Stiff Soil" Risk Category I/II/III Stanwood, N\ EBEY HILL ��, NAVAL PESEVATION ;�ISA�1 Srl1LA6t l5N RES_rR"T)&I BAY Arlington no 11 'Warm Beach I 1 R_INv 0NMUNIA1.9PDRT 4 T AAL P RESER11AT,ON Granite Falls USGS—Provided Output SS = 1.066 g SMs = 1.145 g Sps = 0.763 g S1 = 0.415 g SMl = 0.658 g SDI = 0.439 g For information on how the SS and S1 values above have been calculated from probabilistic (risk-targeted) and deterministic ground motions in the direction of maximum horizontal response, please return to the application and select the"2009 NEHRP"building code reference document. 'M^FER R*sponte Spectrum rietign Response Sp&ctrum aas 1M (Lau IM azn Q56 Q64 "L Mtos Q 72 a4a CQFl QA � QSYI asa 0. asp Q.?A all, wry 0 1% am a' am abo QS7 Q.ea aU] aW Im 1_V 1.4a 1.0 It_7W aco ara CLAQ Cl00 aDJ 1.03 1.20 1_40 1.03 MW 20U Period.r(sec) Pe"lod,T(sec) Although this Information Is a product of the U.S.Geological Survey,we provide no warranty, expressed or Implied, as to the accuracy of the data contained therein.This tool Is not a substitute for technical subject-matter knowledge. 1 of 1 7/20/2017 4:49 PM r e P �-�4;- em s A p g� a-76 -44 �,o Coy-763) 17 46 x z� VL Z -K p OAJ C' �rli Ito R �r Lf A TOPS. 35500 . i � K t Project:grow rooms r;fc� page - — Peter Chopelas Location:typical ceiling beam 7 Chopelas and associates / Multi-Span Floor Beam ,. 307 N. Olympic Ave,suite 208 of [2012 International Building Code(2012 NDS)] l �;;'� Arlington,WA 98223 5.125 IN x 13.5 IN x 21.33 FT Ln�'24F-V4-Visually Graded Western Species-Dry Use StruCalc Version 9.0.2.5 7/24/2017 11:15:59 AM Section Adequate By: 7.0% Controlling Factor:Moment DEFLECTIONS Cen er LOADING DIAGRAM Live Load 0.86 IN U297 Dead Load 0.38 in Total Load 1.24 IN U206 Live Load Deflection Criteria: L/180 Total Load Deflection Criteria: L/120 REACTIONS e B Live Load 3733 lb 3733 Ib Dead Load 1653 lb 1653 lb Total Load 5386 lb 5386 lb Bearing Length 1.62 in 1.62 in BEAM DATA Center Span Length 21.33 ft Unbraced Length-Top 0 ft A 21.33ft-- Unbraced Length-Bottom 21.33 ft B Floor Duration Factor 1.00 Camber Adj.Factor 1.5 Camber Required 0.57 FLOOR LOADING Center Notch Depth 0.00 Floor Live Load FLL= 25 psf MATERIAL PROPERTIES Floor Dead Load FDL= 10 psf Floor Tributary Width Side One TW1 = 7 ft 24F-V4-Visually Graded Western Species Base Values Adjusted Floor Tributary Width Side Two TW2= 7 ft = Bending Stress: Fb= 2400 psi Controlled by: Wall Load WALL 0 plf Fb_cmpr= 1850 psi Fb'= 2368 psi BEAM LOADING Center Cd=1.00 Cv=0.99 Reduced Floor Live Load 25 psf Shear Stress: Fv= 265 psi Fv'= 265 psi Total Live Load 350 plf Cd=1.00 Total Dead Load 140 plf Modulus of Elasticity: E= 1800 ksi E'= 1800 ksi Beam Self Weight 15 plf Comp.-L to Grain: Fc-1= 650 psi Fc-1'= 650 psi I Total Load 505 plf Controlling Moment: 28720 ft-lb 10.66 Ft from left support of span 2(Center Span) Created by combining all dead loads and live loads on span(s)2 Controlling Shear: 5386 lb At left support of span 2(Center Span) Created by combining all dead loads and live loads on span(s)2 Comparisons with required sections: Read Provided Section Modulus: 145.53 in3 155.67 in3 Area(Shear): 30.49 in2 69.19 in2 Moment of Inertia(deflection): 636.76 in4 1050.79 in4 Moment: 28720 ft-lb 30722 ft-lb Shear: 5386 lb 12223lb NOTES Y r r. h Project:grow rooms -peter Chopelas Location:COL3 Chopelas and associates Column _. 307 N.Olympic Ave,suite 208 [2012 International Building Code(2012 NDS)] rl Arlington,WA 98223 5.5 IN x 7.5 IN x 9.0 FT - g #2- Hem-Fir-Dry Use StruCalc Version 9.0.2.5 7/24/2017 11:16:21 AM Section Adequate By: 19.4% vl VERTICAL REACTIONS LOADING DIAGRAM Live Load: Vert-LL-Rxn= 7000 lb Dead Load. Vert-DL-Rxn= 2869 lb Total Load: Vert-TL-Rxn= 9869 lb 1 COLUMN DATA Total Column Length: 9 ft Unbraced Length(X-Axis)Lx: 9 ft Unbraced Length(Y-Axis)Ly: 9 ft Column End Condtion-K(a): 1 Load Eccentricity(X-Axis)-ex: 0.5 in Load Eccentricity(Y-Axis)-ey: 0.5 in Axial Load Duration Factor 1.00 COLUMN PROPERTIES #2 -Hem-Fir Base Values Adiusted Compressive Stress: Fc= 575 psi Fc'= 464 psi Cd=1.00 Cp=0.81 oft Bending Stress(X-X Axis): Fbx= 575 psi Fbx'= 573 psi Cd=1.00 CF=1.00 C1=1.00 Bending Stress(Y-Y Axis): Fby= 575 psi Fby'= 575 psi Cd=1.00 CF=1.00 Modulus of Elasticity: E= 1100 ksi E'= 1100 ksi Column Section(X-X Axis): dx= 7.5 in Column Section(Y-Y Axis): dy= 5.5 in Area: A= 41.25 in2 Section Modulus(X-X Axis): Sx= 51.56 in3 Section Modulus(Y-Y Axis): Sy= 37.81 in3 Slenderness Ratio: Lex/dx= 14.4 A Ley/dy= 19.64 Column Calculations(Controlling Case Only): AXIAL LOADING Live Load: PL= 7000 lb Controlling Load Case:Axial Total Load Only(L+D) Dead Load: PD= 7000 Ib Actual Compressive Stress: Fc= 239 psi Column Self Weight: CSW= 69 Ib Allowable Compressive Stress: Fc'= 464 psi Total Load: CS= 9869 Ib Eccentricity Moment(X-X Axis): Mx-ex= 408 ft-lb Eccentricity Moment(Y-Y Axis): My-ey= 408 ft-lb Moment Due to Lateral Loads(X-X Axis): Mx= 0 ft-lb Moment Due to Lateral Loads(Y-Y Axis): My= 0 ft-lb Bending Stress Lateral Loads Only(X-X Axis): Fbx= 0 psi Allowable Bending Stress(X-X Axis): Fbx'= 573 psi Bending Stress Lateral Loads Only(Y-Y Axis): Fby= 0 psi Allowable Bending Stress(Y-YAxis): Fby'= 575 psi Combined Stress Factor: CSF= 0.81 NOTES Project:grow rooms n'I+'r Peter Chopelas Location: ceiling joist ',l Chopelas and associates Floor Joist a 307 N.Olympic Ave,suite 208 2012 International BuildingCode(2012 NDS of )) ��� :� —Arlington,WA 98223 1.51Nx7.251Nx14.2FT @80.C. i �, #2- Hem-Fir-Dry Use ` J Y�Y t '1��� StruCalc Version 9.0.2.5 7/24/2017 11:16:47 AM Section Adequate By: 131.6% Controlling Factor:Moment DEFLECTIONS Center LOADING DIAGRAM Live Load 0.25 IN L/692 Dead Load 0.08 in Total Load 0.32 IN L/524 Live Load Deflection Criteria:L/180 Total Load Deflection Criteria: L/120 REACTIONS A B Live Load 118 Ib 118 lb Dead Load 38 lb 38 lb Total Load 156 lb 156 lb Bearing Length 0.26 in 0.26 in SUPPORT LOADS A B Live Load 177 plf 177 plf Dead Load 57 plf 57 plf 14.2 ft —� Total Load 234 plf 234 plf A B MATERIAL PROPERTIES #2-Hem-Fir JOIST DATA Cen r Base Values Adjusted Span Length 14.2 ft Bending Stress: Fb= 850 psi Fb'= 1173 psi Unbraced Length-Top 0 ft Cd=1.00 CF=1.20 Cr-1.15 Unbraced Length-Bottom 0 ft Shear Stress: Fv= 150 psi Fv'= 150 psi Floor sheathing applied to top of joists-top of joists fully braced. Cd=1.00 Modulus of Elasticity: E= 1300 ksi E'= 1300 ksi Sheathing/sheetrock applied to bottom of joists-bottom of joists fully braced. Floor Duration Factor 1.00 Comp.-L to Grain: Fc-1= 405 psi Fc--L = 405 psi JOIST LOADING Controlling Moment: 555 ft-lb Uniform Floor Loading Cen er 7.1 Ft from left support of span 2(Center Span) Live Load LL= 25 psf Created by combining all dead loads and live loads on span(s)2 Dead Load DL= 8 psf Controlling Shear: 156 lb Total Load TL= 33 psf At left support of span 2(Center Span) TL Adj.For Joist Spacing wT= 22 plf Created by combining all dead loads and live loads on span(s)2 Comparisons with required sections: Read Provided Section Modulus: 5.67 in3 13.14 in3 Area(Shear): 1.56 in2 10.88 in2 Moment of Inertia(deflection): 12.39 in4 47.63 in4 Moment: 555 ft-lb 1284 ft-lb Shear: 156 lb 10881b NOTES Project:grow rooms yfr'. Page - -- ' Pelar as / Location:ceiling joist(max span) ChUpelas las and associates Floor Joist 307 N.Olympic Ave,suite 208 of [2012 International Building Code(2012 NDS)] .Y Aflington,WA 98223 1.5 IN x 7.25 IN x 14.2 FT @16O.C. #2-Hem-Fir-Dry Use StruCalc Version 9.0.2.5 8/3/2017 5:38:45 PM Section Adequate By:15.8% Controlling Factor:Moment DEFLECTIONS Center LOADING DIAGRAM Live Load 0.49 IN L/346 Dead Load 0.16 in Total Load 0.65 IN L/262 Recelved Live Load Deflection Criteria:1_/180 Total Load Deflection Criteria:L/120 REACTIONS P� B [��G Live Load 237 lb 237 lb Dead Load 76 lb 76 lb Total Load 313 lb 313 lb Bearing Length 0.51 in 0.51 in SUPPORT LOADS A B Live Load 178 plf 178 pit —� —— Dead Load 57 plf 57 pit A - 14.2 n - B Total Load 235 plf 235 plf MATERIAL PROPERTIES #2-Hem-Fir JOIST DATA Center Base Values Adjusted Span Length 14.2 ft Bending Stress: Fb= 850 psi Fb'= 1173 psi Unbraced Length-Top 0 ft Cd=1.00 CF=1.20 Cr-1.15 Unbraced Length-Bottom 0 ft Shear Stress: Fv= 150 psi Fv'= 150 psi Floor sheathing applied to top of joists-top of joists fully braced. Cd=1.00 Sheathing/sheetrock applied to bottom ofjoists-bottom ofjoists fully braced. Modulus of Elasticity: E= 1300 ksi E'= 1300 ksi Floor Duration Factor 1.00 Comp.-L to Grain: Fc--L= 405 psi Fc--L'= 405 psi JOIST LOADING Controlling Moment: 1109 ft-lb Uniform Floor Loading CenterL= 25 psf 7.1 Ft from left support of span 2(Center Span) Live Load Dead Load L L= 8 psf' Created by combining all dead loads and live loads on span(s)2 Total Load TL= 33 psf Controlling Shear: 312 lb TL Adj.For Joist Spacing wT= 44 plf At left support of span 2(Center Span) Created by combining all dead loads and live loads on span(s)2 Comparisons with required sections: Read Provided Section Modulus: 11.35 in3 13.14 in3 Area(Shear): 3.12 in2 10.88 in2 Moment of Inertia(deflection): 24.77 in4 47.63 in4 Moment: 1109 ft-lb 1284 ft-lb Shear: 312lb 1088lb NOTES 32,p r � V _: Received jjUG ® 7 Mil 11 EXIST. BLDG. COLUMN R-16 INSULATION EXIST. METAL GIRT BEAM BEAM AT EDGE OF DOOR OPENING CORRUGATED - FASTEN TOP PLATE TO METAL SIDING EXIST. METAL GIRT BEAM W/(2) ROWS#8 SCREWS @ 16" OC, STAGG. 18 GA. 2x4 METAL STUDS @ 24" O.C. W/(2)#8 SCREWS 18 GA. HORIZ HAT @ EA. END STRINGERS @ 4'-0" OC -FI O EXTERIOR (o INTERIOR L-SHAPE METAL �� FLASHING FASTEN LOWER PLATE TO CONC. FLOOR W/ 16d CONC. POLYURETHANE NAILS @ 16" OC ADHESIVE CAULK BEAD UNDER FLASHING EXIST. CONC. FLOOR a a Cot' -� 4 a 0 EEXISTING DOOR OPENING INFILL FRAMING DETAIL ill NORTHERN GROW, LLC 19320 63RD AVE NE (,{J ARLINGTON,WA 98223 i City of Arlington Community & Economic Development July 31, 2017 Kenneth Gong 2617 98t" Place SE Everett WA, 98208 RE: Northern Grow LLC, Plan review of submitted documents for the purpose of acquiring a building permit Dear Mr. Gong, Thank you for your submittal and interest in the City of Arlington. I cannot approve your plans at this time as I have the following clarifications and or corrections that need to be identified prior to plan approvals being granted. Please respond to my comments in like fashion,thank you. 1. Sheet 1 of 3—Provide an Egress path of Travel plan per IBC§107.2.3.This shall include emergency pathway lighting and exit illumination per§1008 and §1013 2. Sheet 1 of 3—Provide occupant loads for all spaces, load calculated and required exit sizing per IBC Ch. 10 throughout. 3. Sheet 2 of 3—It is unclear if the exterior walls are to be "furred-out" or not. Further detail is needed for the acceptance of the "Ledger Locks"to the exterior walls. 4. Sheet 2 of 3 -Additional details for the GLB's to existing interior walls and new walls should be provided for construction clarity, i.e. built up post beams under GLB's,fastening requirements etc. 5. Sheet 2 of 3—Provide hardware schedule for the proposed and existing doors complying ICC A117.1-2009 §404.2.6. 6. Sheet 3 of 3—Provide locations of required shear walls onto sheet 2 of 3. 7. Sheet 3 of 3—Provide documentation on plans that there will be no storage or access to "lids" of grow rooms. The provided engineering for the joists of 2X8 at 8 O.0 is not clear if it meets the requirements of IBC CH. 16, Table 1607.1. If this area is for storage please provide commodity to be stored, guard railing requirements, etc. 8. Sheet 3 of 3—Please clarify joist spacing, as mentioned above, per the engineering calculations state at 8" O.C. and the plans state 16" O.C. 9. General note—This structure is required to be sprinkled but I do not see a required riser room. Please identify its location and construction assembly. Please understand that there may be additional plan review comments as this process continues to move forward. I look forward to your reply on these comments and/or corrections. I am available to you should further clarifications be needed or should you want to visit one on one and go over the plan sets. I have sent an e-copy of this correspondence to Mr. Peter Chopelas, P.E. in an effort to assist expediting your re- submittal. Thank you for your attention to these comments. Respectfully, Richard Karns, CBO Building Official City of Arlington Date: 03/20/2026 Permit#: 1563 Permit Date: 07/24/2017 Review Date: 07/26/2017 Permit Type: COMMERCIAL ALTERATION Review Type: COMMERCIAL ALTERATION Target Date: 08/02/2017 Scheduled 00:00 Time: Completed 08/08/2017 Date: Description: There is an existing monitoring manhole at this site, applicant will need to contact Sandy Boyd at 360-403-3539 for pretreatment requirements JL Review Status: Assigned To: PW-SEW-REV Time In: 00:00 Time Out: 00:00 Hours: 0.0 Property Information Parcel#: 31051500401200 CITY OF ARLINGTON CITY OF ARLINGTON 18204 59TH DRIVE NE 19320 63rd Avenue NE ARLINGTON, WA 98223 Zoning: 431 Airports &Flying FieldsLot: 93131ock: Permit#: 1563 Permit Date: 07/24/17 Permit Type: COMMERCIAL ALTERATION Project Name: Northern Grow, LLC Applicant Name: Kenneth Gong Applicant Address: 2617 98th Place SE Applicant, City, State, Zip: Everett,WA 98208 Contact: Kenneth Gong Phone: 26-295-8833 Email: Scope of Work: 1502 Producer/Processor Valuation: 50000.00 Square Feet: 13895 Number of Stories: 1 Construction Type: Occupancy Group: ID Code: Permit Issued: 08/09/2017 Permit Expires: Form Permit Type: Status: COMPLETE Assigned To: Kristin Foster Property Parcel# Address Legal Description Owner Name Owner Phone Zoning 31051500401200 19320 63rd Avenue NE CITY OF 431 Airports& ARLINGTON Flying Fields Contractors Contractor Primary Contact Phone Address Contractor Type License License# 15625 264th CONSTRUCTION Labor d MSCON**099KA MS Construction Michael Sweet Street E CONTRACTOR Industri anes Plan Reviews Date Review Type Description Assigned To Review Status 07/26/2017 COMMERCIAL approved with red lines z.Rick Karns ALTERATION 07/26/2017 COMMERCIALALTERATION No comments at this time,LT PW-ADMIN-GIS COMMERCIAL There is an existing monitoring manhole at this site, 07/26/2017 ALTERATION applicant will need to contact Sandy Boyd at 360-403- PW-SEW-REV 3539 for pretreatment requirements JL COMMERCIAL There is a fire system and a new 2"service required for 07/26/2017 this building.There are no site civil drawings submitted. PW-WAT-REV ALTERATION Unable to complete my review.GS 08/03/2017 BLD ROW permit needed for fire line installation,to track Nova Heaton water line location and inspect installation. Fees Fee Description Notes Amount Building Plan Review Table 4-2 $592.66 Building Permit Table 4-1 $1,091.60 Processing/Technology $25.00 State Surcharge- 1 st DU Residential- 1 st Unit $4.50 Total $1,713.76 Attached Letters Date Letter Description 08/09/2017 Building Permit Payments Date Paid By Description Payment Type Accepted By Amount 07/24/2017 Kenneth Gong 65650759 cc $592.66 08/09/2017 Kenneth Gong 65865267 cc $1,121.10 Outstanding Balance $0.00 Uploaded Files Date File Name 08/14/2017 2525346-1563 Issued Permit.pdf 07/31/2017 2488648-P.R.#1563.docx 07/26/2017 2478824-BLD-GIM 19310 63rd Ave NE.pdf 07/26/2017 2478822-Hong Woo Meeting Minutes.pdf 07/26/2017 2478731-1563 Structurals.pdf 07/26/2017 2478732-1563 Plans.pdf 07/26/2017 2478733-1563 Application.pdf Date: 03/20/2026 Permit#: 1563 Permit Date: 07/24/2017 Review Date: 08/03/2017 Permit Type: COMMERCIAL ALTERATION Review Type: BLD Target Date: Scheduled Time: 00:00 Completed 08/03/2017 Date: Description: ROW permit needed for fire line installation, to track water line location and inspect installation. Review Status: Assigned To: Nova Heaton Time In: 00:00 Time Out: 00:00 Hours: 0.0 Property Information Parcel#: 31051500401200 CITY OF ARLINGTON CITY OF ARLINGTON 18204 59TH DRIVE NE 19320 63rd Avenue NE ARLINGTON, WA 98223 Zoning: 431 Airports &Flying FieldsLot: 93131ock: Date: 03/20/2026 Permit#: 1563 Permit Date: 07/24/2017 Review Date: 07/26/2017 Permit Type: COMMERCIAL ALTERATION Review Type: COMMERCIAL ALTERATION Target Date: 08/02/2017 Scheduled 00:00 Time: Completed 07/26/2017 Date: Description: There is a fire system and a new 2" service required for this building. There are no site civil drawings submitted. 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