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HomeMy WebLinkAbout17410 73RD DR NE_BLD1975_2026 RESIDENTIAL MECHANICAL PERMIT APPLICATION L�NG" Department of Community&Economic Development City of Arlington • 18204 59th Ave NE •Arlington,WA 98223 • Phone(360)403-3551 THIS APPLICATION IS TO BE USED WHEN APPLYING FOR NEW MECHANICAL INSTALLATION AND OR GAS PIPING FOR EXISTING RESIDENCES. PLEASE FILL OUT ALL PAGES OF THIS APPLICATION AND INCLUDE ALL INFORMATION. Project Address: 1V Project Description: - Owner: Address: 1 � !S City: �� Mate: Zip Code: Phone: ____ � �G 6J Email: Applicant: 6k)L,4Ag�Aj4--, Address: b 1-31 :Ik AC:f�61y: c:S State: ( Zip Code: l Phone. 9 f Email,iI i�� CONTRACTOR INFORMATION Contractor Name: AW 1 tLw r Address: �� (p ��LIJ ,Q, City: State: 10h Zip Code: License Number:a4A� /L�- ,jq4S-L P Expiration: '?1/7' Phone: 12� , �d �� Email: s� t E� �J �1'��1�<< t �t STAFF USE O LY Received Permit Accepted by: Date- APR 21 2.018 6/16LP Page 1 of 2 CITY OF ARLINGTON 238 N. OLYMPIC AVE - ARLINGTON, WA. 98223 PHONE; (360) 403-3551 BUILDING PERMIT Address:17410 73rd Ave NE Permit#:1975 Parcel#:01030500003600 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:ANGELA REECE Name:BL Wilson Name:BL Wilson Company Address: 17410 73RD AVE NE Address:6810 Silvana Terrace Rd Address:6810 Silvana Terrace Rd City,State Zip:ARLINGTON,WA 98223 City,State Zip:Stanwood City,State Zip:Stanwood,WA 98292 Phone: Phone:360-652-0165 Phone:360-652-6974 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name:BL Wilson Company Name: Address:6810 Silvana Terrace Rd Address: City,State,Zip:Stanwood,WA 98292 City,State,Zip: Phone:360-652-6974 Phone: LIC#:BLWILC*075LP EXP: 09/17/2018 LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Commercial Mechanical CODE YEAR: 2015 STORIES: 2 CONST.TYPE: ` 13 DWELLING UNITS: I OCC GROUP: R3 BUILDINGS: OCC LOAD: PERMIT APPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPA CY HAS BEEN GRANTED. IBC110/IRC110. SALE:"' N "#" :Sal tax relating to construction and construction materials in the City of A I' i st rC rt on your sales tax return form an code •lin Ito 3101. �� / Sig 'lure Print Name DaI telea ed By Date CONDITIONS Approved as submitted. Additional requirements: Provide 3" concrete pad with seismic bracing attached to pad, provide electrical disconnect, lines shall be insulated- the use of adhesive tape is not permitted. THIS PERMIT AUTHORIZS ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION. PERMIT FEES Date Description Fee Amount 5/21/2018 A/C Unit $25.00 5/21/2018 Furnace $25.00 5/21/2018 Mechanical Fee(Enter Fixture Fee) $25.00 5/21/2018 Processing/Technology Fee $25.00 Total Due: $100.00 Total Payment: $0.00 Balance Due: $100.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon CITY OF ARLINGTON 238 N. OLYMPIC AVE - ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:17410 73rd Ave NE Permit#:1975 Parcel#:01030500003600 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:ANGELA REECE Name:BL Wilson Name:BL Wilson Company Address: 17410 73RD AVE NE Address:6810 Silvana Terrace Rd Address:6810 Silvana Terrace Rd City,State Zip:ARLINGTON,WA 98223 City,State Zip:Stanwood City,State Zip:Stanwood,WA 98292 Phone: Phone:360-652-0165 Phone:360-652-6974 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name:BL Wilson Company Name: Address:6810 Silvana Terrace Rd Address: City,State,Zip:Stanwood,WA 98292 City,State,Zip: Phone:360-652-6974 Phone: LIC#:BLWILC*075LP EXP: 09/17/2018 LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Commercial Mechanical CODE YEAR: 2015 STORIES: 2 CONST.TYPE: ` 13 DWELLING UNITS: 1 OCC GROUP: R3 BUILDINGS: OCC LOAD: PERMIT APPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY; NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPA CY HAS BEEN GRANTED. IBCI IO/IRC1IO. SALES N 'I' ::Sal tax relating to cons fiction and construction materials in the City of A h t rt on your sales tax return form an code fin to 3101. Awe, Sig&cure Print Name 1)at eleased By Date CONDITIONS Approved as submitted. Additional requirements: Provide 3" concrete pad with seismic bracing attached to pad, provide electrical disconnect, lines shall be insulated- the use of adhesive tape is not permitted. THIS PERMIT AUTHORIZE 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 5/21/2018 A/C Unit $25.00 5/21/2018 Furnace $25.00 5/21/2018 Mechanical Fee(Enter Fixture Fee) $25.00 5/21/2018 Processing/Technology Fee $25.00 Total Due: $100.00 Total Payment: $0.00 Balance Due: $100.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon IWORQ Systems Inc. Page 1 of 2 Permit Information Date 5/21/2018 Permit Number 1975 Project Namel Reece Applicant Namel BL Wilson Applicant Address)6810 Silvana Terrace Rd City,State,Zipl Stanwood Contact l Phone 1360-652-0165 Email l`silvanacrest77@msn.com Permit Type Commercial Mechanical Site Address 17410 73rd Ave NE Valuation 0.00 Status Issued Permit Issuedl5/21/2018 Permit Expires) Square Feetl0 Type of Construction/Occupancy Load Number of Stories I 0 Proposed Usel Replace gas furnace and add A/C Assigned To Kristin Foster Property Parcel Address Legal Owner Owner Phone Zoning 01030500003600 17410 73RD DR NE ANGELA REECE 111 Single Family Residence-Detached Contractors Contractor Name Primary Contact Phone Email Contractor Type License License# BL Wilson Company Brock Wilson 360-652-6974 CONTRACTOR Labor and Industries BLWILC*075LP Fees Fee Description Notes Amount A/C Unit 322.10.00.00 $25.00 Furnace 322.10.00.00 $25.00 Mechanical Fee(Enter Fixture Fee) 322.10,00.00 $25.00 Processing/Technology Fee 341.43.00.02 $25.00 Total $100.00 Payments https://www.iworq.net/iworq/Permit/popupPermitEditPrint.asp?sid=JKOIAQLKGBPGMB... 5/22/2018 IWORQ Systems Inc. Page 2 of 2 Date Paid By Amount Description Payment Type Accepted By 5/21/2018 Heat King Mechanical $100.00 Check#6868 Kristin Foster Total $100.00 Amount Outstanding:$0.00 Uploaded Files Upload File Date File Uploaded By https://www.iworq.net/iworq/Permit/popupPermitEditPrint.asp?sid=JKOIAQLKGBPGMB... 5/22/2018 ry RESIDENTIAL MECHANICAL PERMIT APPLICATION Department of Community&Economic Development City of Arlington • 18204 59th Ave NE •Arlington,WA 98223 • Phone(360)403-3551 THIS APPLICATION IS TO BE USED WHEN APPLYING FOR NEW MECHANICAL INSTALLATION AND OR GAS PIPING FOR EXISTING RESIDENCES. PLEASE FILL OUT ALL PAGES OF THIS APPLICATION AND INCLUDE ALL INFORMATION. Project Address. 1",7410- ``�► .U� �_ Project Description: Ak,, Owner: J 2)A Address: / �� � � City: Abm,�rmlate: G(, Zip Code: Phone: :��2n 8l LS- Email: Applicant: L w� -A Address: �Q$jb �l�U A. �� City: `y��C State: Zip Code: "l Phone: - ! � Email:._ Ill"�4)A / c� ' CONTRACTOR INFORMATION Contractor Name: e�­ !F c tea)7T Address: 6�WlQ —SG deg0A, City: State: GL)l9' Zip Code: �n License Number:aLu) /Lel- CS �rL Expiration: /7 Phone:. , �d7 Email: s 11140JA ZX �I C NS,AL dWtt STAFF USE ONLY / Received .i APR 2l. 2018 Permit#: 1°l'1� Accepted by: Date: 6/16LP Page 1 of 2 RESIDENTIAL MECHANICAL � 1 PERMIT APPLICATION r�PllNf Department of Community&Economic Development City of Arlington • 18204 59th Ave NE •Arlington,WA 98223 • Phone(360)403-3551 SELECT ALL PROPOSED APPLIANCES ❑ Furnace (80+) Model# AFUF ❑ Heat Pump Model# AFUE HSPE ❑ AC Unit Model# SEER ❑ Freestanding Stove ❑ Fire Place Insert ❑ Outdoor BBQ ❑ Gas Piping ❑ Solid-Fuel Appliance ❑ Other Gas Piping Information Not Applicable: ❑ Pipe Material: Pipe Size: Distance from Meter to Furthest Appliance: Total BTU's of all Appliances: i New gas piping requires a pressure test hooking to any appliance • Sediment traps (drips) are required on all gas lines O Gas lines are required to be supported/secured every 6 to 8 feet • Proper Combustion air and venting required for all appliances • A shut-off valve is required within 6 feet of all appliances Applicant Signature: Date: Applicant Printed Name: I hereby certify that the above information is correct and that the construction, installation for the above, mentioned property will be in accordance with the applicable laws of the City of Arlington and the State of Washington. 6/16LP Page 2 of 2 ifo3n ;>o-r,'2uluinci Search L&I ,A-7.(nJk,t i Iclp .ilc 1141 Safe[;&Health Claims&Insurance Workplace Rights Trades & Licensing Washington State Department of " Labor & Industries B L WILSON COMPANY Owner or tradesperson 6810 SILVANA TERRACE RD Principals STANWOOD,WA 98292 360-652-6974 WILSON,BROCK LEONARD,OWNER SNOHOMISH County Doing business as B L WILSON COMPANY WA UBI No. Business type 601 381 377 Individual Governing persons BROCK LEONARD WILSON CAROL J WILSON; 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. BLWILC*075LP Effective—expiration 06/17/1993—09/17/2018 Bond WESTERN SURETY CO $12,000.00 Bond account no. 24345420 Received by L&I Effective date 05/09/2002 05/26/2002 Expiration date Until Canceled Insurance Ohio Security Ins Co $1,000,000.00 Policy no. BKS54577132 Received by L&I Effective date 08/01/2017 09/17/2017 Expiration date 09/17/2018 Insurance history Savings ................. No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. Help gas improve L&I Tax debts No L&I tax debts are recorded for this coik..Actor license during the previous 6 year period,but so...e debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. Workers' comp Do you know if the business has employees?If so,verify the business is up-to-date on workers'comp premiums. L&I Account ID Account is current. 260,833-00 Doing business as HEAT KING MECHANICAL Estimated workers reported Quarter 1 of Year 2018"Less than 1 Workers" L&I account contact T3/STEPHANIE HENDERSON(360)902-5598-Email:HSTE235@Ini.wa.gov Public Works Strikes and Debarments Verify the contractor is eligible to perform work on public works projects. Contractor Strikes No strikes have been issued against this contractor. Contractors not allowed to bid No debarments have been issued against this contractor. Workplace safety and health No inspections during the previous 6 year period. Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. _ ; ._ �f:ate ,�_��-� • -,� - � •a L +♦ _ O . � A O A A R, In MOW T i M i ' I •.fz� 41 i `' ti�A i I I BUILDING INSPECTION REPORT — MECHANICAL (RESIDENTIAL) Permit No. 1975 Address: 17410 73rd Ave NE Contractor: BL Wilson Company Owner: ANGELA REECE Date: 6/8/2018 ® APPROVAL ❑ PARTIAL APPROVAL ❑ CORRECTION ❑ OTHER APPLIANCE: Gas Furnace &AC CO DETECTOR: ❑ HEAT PUMP/AC UNIT: GAS PIPING: © DISCONNECT: DRIP LEG: ® SEISMIC: VENTING: ® 3" PAD: ACCESS: ® INSULATION/PROTECTION: SHUT-OFF VALVE: nx DUCTS: N/A L&I: N/A Date: 6/8/2018 Inspector: Kevin Olander Permit#: 1975 Permit Date: 05/21/18 Permit Type: COMMERCIAL MECHANICAL Project Name: Reece Applicant Name: BL Wilson Applicant Address: 6810 Silvana Terrace Rd Applicant, City, State, Zip: Stanwood Contact: Phone: 360-652-0165 Email: silvanacrest77@msn.com Scope of Work: Replace gas furnace and add A/C Valuation: 0.00 Square Feet: 0 Number of Stories: 0 Construction Type: Occupancy Group: ID Code: Permit Issued: 05/21/2018 Permit Expires: Form Permit Type: Status: LASERFICHE Assigned To: Property Parcel# Address Legal Description Owner Name Owner Phone Zoning 01030500003600 17410 73RD DR NE ANGELA REECE 111 Single Family Residence-Detached Contractors Contractor Primary Contact Phone Address Contractor Type License License# BL Wilson Company Brock Wilson 360-652-6974 6810 Silvana CONSTRUCTION Labor andBLWILC*075LP Terrace Rd CONTRACTOR Industries Inspections Date Inspection Type Description Scheduled Date Completed Date Inspector Status 06/12/2018 R00.HEAT PUMP/ 06/08/2018 BUILDING Approved AC UNIT FINAL 06/12/2018 R00.FURNACE 06/08/2018 BUILDING Approved FINAL Fees Fee Description Notes Amount Air Cond.Unit Btu/h<100>; $25.00 Btu/hp>500 Forced Air Heat fee per Btu $25.00 Mechanical Fee(Enter Fixture Fee) $25.00 Processing/Technology $25.00 Total $100.00 Attached Letters Date Letter Description 05/21/2018 Building Permit Payments Date Paid By Description Payment Type Accepted By Amount 05/21/2018 Heat King Mechanical Check#6868 Kristin Foster $100.00 Outstanding Balance $0.00 Uploaded Files Date File Name 06/12/2018 3601336-17410 73RD AVE NE.docx 05/22/2018 3517665-1975 Application.pdf 05/22/2018 3517666-1975 Issued Permit.pdf