HomeMy WebLinkAbout2430 STATE ROUTE 530_BLD2051_2026 l
C1 CY OF ARLINGTON
238 N. OLYMPIC AVE - ARLINGTON, WA. 98223
PHONE; (360)403-3551
BUILDING PERMIT
Address:2430 State Route 530 Permit#:2051
Parcel#:31050800300300 Valuation:2000000.00
OWNER APPLICANT CONTRACTOR
Name:PILOT TRAVEL CENTERS LLC Name:Pilot Travel Centers,LLC Name:Pilot Travel Centers,LLC
Address:5508 LONAS ROAD Address:5508 Lonas Road Address:5509 Lonas Road
City,State Zip:KNOXVILLE,TN 37909 City,State Zip:Knoxville,TN 37909 City,State Zip:Knoxville,TN 37909
Phone: Phone: 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: Commercial New CODE YEAR: 2015
STORIES: CONST.TYPE:
DWELLING UNITS: 0 OCC GROUP:
BUILDINGS: Vehicle Fuel Canopy OCC LOAD:
PERMIT APPROVAL
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY,
NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S
COMPENSATION INSURANCE AND RCW 18.27.
THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID.
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBC110/IRC110.
SALES TAX NOTICE:Sales tax rel ting to construction and construction materials in the City of Arlington must be repo your tax return form
and • do f •1 t�#3 l �e 7S
1g
ibnature Print Name Date RoW99 y Date
CONDITIONS
Adhere to approved plans.
THIS PERMIT AUTHORIZS ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION
ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION.
PERMIT FEES
Date Description Fee Amount
7/13/2018 Building Permit Fee $2,283.58
7/13/2018 Building Plan Review Fee $1,484.33
7/13/2018 Processing/Technology Fee $25.00
7/13/2018 State Surcharge-Commercial $25.00
Total Due: $3,817.91
Total Payment: $0.00
Balance Due: $3,817.91
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
r ..
Y Off,
COMMERCIAL APPLICATION
jti��o� PERMIT SUBMITTAL
Department of Community& Economic Development
City of Arlington • 18204 59th Ave NE•Arlington, WA 98223 • Phone (360)403-3551
THIS APPLICATION TO BE USED FOR NEW COMMERCIAL STRUCTURES AND RESIDENTIAL DWELLINGS NOT REGULATED UNDER THE
IRC. THIS APPLICATION MUST BE ACCOMPANIED BY A COMMERCIAL APPLICATION SUBMITTAL CHECKLIST AND AN OCCUPANT'S
STATEMENT OF INTENDED USE.
Name of Project: D/�� /Ulw � Valuation
�
Project Address:�Y�� �L— //�G "l
Parcel ID#: Legal Description
Owner: Phone Number:
Address: City: State: Zip Code
Engineer: Phone Number:
Cell Phone: E-mail:
Address: City: State: Zip Code:
General Contractor: Phone Number: r—T ,�
Cell Phone:� ������7 E-mail: ,�,� AZ
Address: L/ City:/ State: Zip Code:
Contractor's License Number:Q Z� 9T W...1 z Expiration
Contact Person: rc1 Xi Phone Number:
Cell Phone: — E-mail:
Address: City: State: Zip Code:
Proposed Scope of Work:��p( 4NIe Wv
�1
REV 2015 Page 6 of 9
�*Y o
COMMERCIAL APPLICATION
PERMIT SUBMITTAL
Department of Community&Economic Development ent
City of Arlington • 18204 59th Ave NE •Arlington, WA 98223 • Phone (360)403-3551
The building permit does not include any mechanical, electrical, plumbing or fire sprinkler/alarm work. These permits are
issued separately. Mechanical, electrical, plumbing, or fire sprinkler/alarm permits require a separate permit application
and may also require separate plan review.
Please note that any tenant improvement work in a space that involves food handling or preparation requires Snohomish
County Health District approval before the permit can be issued. You must provide the Permit Center a copy of the
approval letter or the approved plans. Contact the Snohomish County Health District at(425) 339-5250 with any questions
or for more information.
An intake appointment is required for all large Tenant Improvement Building Permit Applications. To determine if your
project requires an intake appointment,to schedule an appointment or to ensure that you have the most current
information, please contact the City of Arlington Permit Center at(360)403-3551 or by email to ced@arlingtonwa.gov.
Incomplete applications will not be accepted.
I acknowledge that all items designated as submittal requirements must accompany my Building Permit Application to be
considered a complete submittal.
REV 2015 Page 5 of 9
fit,y
COMMERCIAL APPLICATION
PERMIT SUBMITTAL
Department of Community&Economic Development
City of Arlington • 18204 59th Ave NE•Arlington, WA 98223 • Phone (360)403-3551
j) Show the location of all new walls,doors,windows, etc.
k) Provide details and assembly numbers for any fire resistive assemblies.
1) Indicate on the plans all rated walls, doors,windows and penetrations.
m) Provide a legend that distinguishes existing walls,walls to be removed and new walls.
3. ❑ Reflected Ceiling Plan
a) Plan view 1/8"minimum scale. Details a minimum%-inch scale.
b) Provide ceiling construction details.
c) Provide suspended ceiling details complying with IBC 803.9.1.1. Show seismic bracing details
d) Show the location of all emergency lighting and exit signage.
e) Detail the seismic bracing of the fixtures.
f) Include a lighting fixture schedule.
4 ❑ Framing Plan
a) Specify the size,spacing, span and wood species or metal gage for all stud walls.
b) Indicate all wall, beam and floor connections.
c) Detail the seismic bracing for all walls.
d) Include a stair section showing rise, run, landings, headroom, handrail and guardrail dimensions.
5. ❑ Storage Racks(if applicable)
a) Structural calculations are required for seismic bracing of storage racks eight feet or greater in height.
b) Eight feet or less,show a positive connection to floor or walls.
NOTE: High pile storage shall meet the requirements of current International Building and Fire Codes.
C. ❑ SPECIAL INSPECTION
1. Where special inspection is required by IBC 1704,the registered design professional in responsible charge shall prepare
a special inspection program that will be submitted to the City of Arlington and approved prior to issuance of the building
permit to comply with IBC 106 1.
D. ❑ WASHINGTON STATE ENERGY CODE
1. One(1)completed Washington State Non-Residential Energy Code Envelope Summary forms.
E. OCCUPANT'S STATEMENT OF INTENDED USE
1. The Occupant's Statement of Intended Use form shall be completely filled out and may require the submittal of a
Hazardous Materials inventory Statement(HMIS). Contact the Arlington
REV 2015 Page 4 of 9
� A o,.
COMMERCIAL APPLICATION
fs
��G`� PERMIT SUBMITTAL
Department of Community& Economic Development
City of Arlington • 18204 59th Ave NE•Arlington, WA 98223 • Phone(360)403-3551
DETAILED SUBMITTAL REQUIREMENTS
Mark each box to designate that the information has been provided. Please submit this checklist as part of your submittal documents
A. ❑ SITE PLAN—.REQUIRED WITH ALL SUBMITTALS
(May be included as part of the Architectural Drawing cover Sheet)
1 Drawing shall be prepared at scale not to exceed 1"=20 feet.
2. Show building outline and all exterior improvements.
3. Provide property legal description and show property lines.
4. Provide dimensions from the property lines to a minimum of two building corners(or two identifiable locations for
irregular plan shapes).
5. Show building setbacks,easements and street access locations.
6. Indicate North direction.
7 Indicate finish floor elevation for the first level.
8 Provide topographical map of the existing grades and the proposed finished grades with maximum five feet elevation
contour lines.
9. Show the location of all existing underground utilities, including water, sewer,gas and electrical.
10 Flood hazard areas,floodways, and design flood elevations as applicable.
B. ❑ ARCHITECTURAL DRAWINGS
1 ❑ Cover Sheet
a) Building Information
1 Specify model code information.
2 Construction Type.
3 Number of stories and total height in feet.
4 Building square footage(per floor and total)
5 IBC Occupancy Type(show all types by floor and total).
6 Mixed-use ratio(if applicable)
7 Occupant load calculation(show by occupancy type and total)
8 List work to be performed under this permit
b) Design Team Information
1 Design Professional in Responsible Charge
2 Architects
3 Structural Engineers
4 Owner
5 Developer
6 Any other Design Team Members
2 ❑ Floor Plan
a) Plan view 1/8"minimum scale. Details a minimum%-inch scale.
b) Plans must show the entire tenant space.
c) Specify the use of each room/area.
d) Provide an occupant load calculation on the floor plan. (on every floor, in all rooms and spaces)
e) Show ALL exits on the plans; include new, existing or eliminated
f) Show Barrier-Free information on the drawings
g) Show the location of all permanent rooms,walls and shafts.
h) Note the uses in the adjacent tenant spaces, if applicable.
i) Provide a door and door hardware schedule.
REV 2015 Page 3 of 9
i
V 1
COMMERCIAL APPLICATION
PERMIT SUBMITTAL
�1r0� Department of Community&Economic Development
City of Arlington • 18204 59th Ave NE•Arlington, WA 98223 • Phone (360)403-3551
A. FEES DUE AT TIME OF PERMIT ISSUANCE
B. CODES
The City of Arlington currently enforces the following:
International Codes
1. 2015 International Building Code(IBC)
2. 2015 International Residential Code(IRC)
3. 2015 International Mechanical Code(IMC)
4. 2015 International Fuel Gas Code(IFGC)
5. 2015 International Fire Code(IFC)
6. 2015 International Plumbing Code(IPC)
7. 2015 International Property Maintenance Code(IPMC)
8. 2015 International Existing Property Code(IEBC)
9. 2015 Washington State Energy Code(WESC)
10 2009 Accessible& Usable Buildings and Facilities(ICC/ANSI 1417.1)
Washinqton State Amendments
1. WAC 51-50 Washington State Building Code
2. WAC 51-51 Washington State Residential Code
3 WAC 51-52 Washington State Mechanical Code
4. WAC 51-54 Washington State Fire Code
5. WAC 51-56&51-57 Washington State Plumbing Code and Standards
6. WAC 51-11 Washington State Energy Code
7. WAC 296-46B Electrical Safety Standards,Administration, and Installation
C. CITY OF ARLINGTON DESIGN REQUIREMENTS
Design Wind Speed: 85 miles per hour(Exposure C)
Ground Snow Load: 25 pounds per square foot
Seismic Zone: D2
Rainfall: 2 inches per hour for roof drainage design.
Frost Line Depth: 12 inches
Soil Bearing Capacity 1,500 psf unless a Geo-Technical Report is provided. (IBC Table 1804.2&IRC R401.4.1)
D. PLANS AND DRAWINGS
Submit two(2)complete sets of drawings and plans. Drawings and plans must be submitted on minimum 18"X 24", or maximum
30"X 42"paper.All sheets are to be the same size and sequentially labeled. Plans are required to be clearly legible,with scaled
dimensions, in indelible ink, blue line, or other professional media. Plans will not be accepted that are marked preliminary or not
for construction,that have red lines,cut and paste details or those that have been altered after the design professional has
signed the plans.
Please Note:A separate submittal of plans is required for each building or structure.
REV 2015 Page 2 of 9
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` f COMMERCIAL APPLICATION
PERMIT SUBMITTAL
�NG`t� Department of Community& Economic Development
City of Arlington • 18204 59th Ave NE-Arlington,WA 98223 • Phone (360)403-3551
The following minimum information is required for your Commercial/Multi-Family Building Permit
Application. Mark each box to designate that the information has been provided. Please submit this
checklist as part of your submittal documents. Incomplete applications will delay the review.
❑ One(1) City of Arlington Commercial/Multi-Family Permit Application
(One(1) permit application per building or structure is required)
❑ One(1)City of Arlington Commercial/Multi-Family Submittal Requirements Form
❑ Two(2)Architectural Drawings
❑ Two (2) Structural Drawings
❑ Two(2) Structural Calculations
❑ One(1) Project Specification Manuals(if applicable)
❑ One(1) NREC Code Compliance Forms
❑ One(1) Special Inspection Requirements Forms
❑ One(1) Occupant's Statement of Intended Use Form
Drawings shall be BOUND SEPARATELY BY TYPE, architectural, structural and landscape, and then
ROLLED TOGETHER IN COMPLETE SETS>
An intake appointment is required for all new Commercial or Multi-Family Building Permit Applications.
To schedule an appointment please contact the City of Arlington Permit Center at(360) 403 3551 or by
email to ced(Warlingtonwa.gov.
I acknowledge that all items designated above are included as part of this application.
REV 2015 Page 1 of 9
COMMERCIAL APPLICATION
�' PERMIT SUBMITTAL
ill�G�
� Department of Community& Economic Development
City of Arlington • 18204 59th Ave NE•Arlington, WA 98223 • Phone (360)403-3551
Project Name/Tenant )//b/hffz�r1 z6b zm--'5�
Site Address Z/* k LZ & �&/%1 //Jd 9q,�4� Bldg/Unit/Suite
IBC Construction Type? IBC Occupancy Type
Description of Use lAw /9;� 2/c f
,/
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.
Statement of Special Inspection
REV 2015 Page 7 of 9
COMMERCIAL APPLICATION
PERMIT SUBMITTAL
Department of Community& Economic Development
City of Arlington • 18204 59th Ave NE•Arlington,WA 98223 • Phone (360)403-3551
Name of Project:
Project Address:
Special Inspection Firm:
Address:
Contact Person: Phone:
Email:
Special Inspection Firm Special Inspectors:
The Special inspection Firm of will perform special inspection for
the following types of work(separate forms must be submitted if more than one firm is to be employed).
( ) Reinforced Concrete
( ) Bolting in Concrete
( ) Pre-stressed Concrete
( ) Shotcrete
( ) Structural Masonry
( ) Structural Steel and Welding
( ) High-Strength Bolting
( ) Spray-Applied Fireproofing
( ) Smoke-Control Systems
( ) Other Specify
All individual inspectors to be employed on this project will be WABO certified for the type of inspection they are to perform. If inspection
is for work that is not covered by the WABO categories, a detailed resume of the inspector and firm must be submitted. The resume
must show the inspector and firm are qualified to perform the work and testing required by the project design and specifications.
The work shall be inspected for conformance with the plans and specifications approved by the City. Revisions and addenda sheets will
not be used for inspection unless approved by the City.The special inspector shall report to the City revisions that are not approved.
A daily record will be maintained on site itemizing the inspections performed, for the review of all parties.Any nonconforming items shall
be brought to the immediate attention of the contractor for resolution A weekly shall be submitted to the City; detailing the inspections
and testing performed, listing any nonconforming items and resolution of nonconforming items Unresolved nonconforming items will be
detailed on a discrepancy report and presented to the building department.
A final report shall be submitted to the Building Division prior to the Certificate of Occupancy being issued This report will indicate that
inspection and testing was completed in conformance with the approved plans, specifications and approved revisions and addenda.
Any unresolved discrepancies must be detailed in the final report.
The special inspector and special inspection firm serve in the role as"deputy"City of Arlington inspectors and as such are responsible
to the City of Arlington Building Division in the performance of the required work.
Contractor:
The contractor shall provide the special inspector or agency adequate notification of work requiring inspection
The City approved plans and specifications must be made available, at the job site for the use of the special inspector and the City
Inspector The contractor shall maintain all daily inspections reports, on site,for review.
REV 2015 Page 8 of 9
�- COMMERCIAL APPLICATION
PERMIT SUBMITTAL
ill G� Department of Community& Economic Development
City of Arlington • 18204 59th Ave NE•Arlington, WA 98223 • Phone(360)403-3551
The special inspection functions are considered to be in addition to the normal inspections performed by the City and the contractor is
responsible for contacting the City to schedule regular inspections. No concrete shall be poured or other work covered until approved
by the City Inspector.
Building Division:
The Building Division shall review any revisions and addenda.Approved copies will be given to the contractor to maintain as part of the
approved plan set.
The City Inspector will monitor the special inspection functions for compliance with the agreement and the approved plans.
The City Inspector shall be responsible for approving various stages of construction to be covered and work to proceed.
Design Professionals:
The architect and engineer will clearly indicate on the plans and specifications for the specific types of special inspection required, and
shall include a schedule for inspection and testing.
The architect and engineer will coordinate their revisions and addenda process in such a way as to insure all required City approvals
are obtained, prior to work shown on the revisions being performed.
Owner:
The project owner, or the architect or engineer acting as the owners agent, shall employ the special inspector or agency.
ENFORCEMENT:
A failure of the special inspector or firm to perform in keeping the requirements of the IBC,the approved plans and this document may
void this agreement and the Building Officials approval of the special inspector. In such case a new special inspector and/or firm would
need to be proposed for approval.A failure of the design and/or construction parties to perform in accordance with this agreement may
result in a STOP WORK notice being posted on the project, until nonconforming items have been resolved.
ACKNOWLEDGEMENTS
I have read and agree to comply with the terms and conditions of this agreement.
Owner: - Date:
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
Print Applicants Name Date
FOR STAFF USE ONLY
Permit# Accepted By Amount Received Receipt# Date Received
REV 2015 Page 9 of 9
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`AY
COMMERCIAL APPLICATION
PERMIT SUBMITTAL
I l' Department of Community& Economic Development
City of Arlington • 18204 59th Ave NE•Arlington,WA 98223 • Phone (360)403-3551
THIS APPLICATION TO BE USED FOR NEW COMMERCIAL STRUCTURES AND RESIDENTIAL DWELLINGS NOT REGULATED UNDER THE
IRC. THIS APPLICATION MUST BE ACCOMPANIED BYA COMMERCIAL APPLICATION SUBMITTAL CHECKLIST AND AN OCCUPANT'S
STATEMENT OF INTENDED USE.
Name of Project: /�//�� � -( / Valuation:
ProjectAddress:�Y � /fit� //��G
Parcel ID#: Legal Description
Owner: Phone Number:
Address: City: State: Zip Code:
Engineer: Phone Number:
Cell Phone: E-mail:
Address: City: State: Zip Code:
General Contractor: (� Phone Number:
Cell Phone:, -?6 M 7 E-mail: 641. _
Address: //City: State: Zip Code:
Contractor's License Number: / �� )�V_f z Expiration
Contact Person: To Phone Number:
Cell Phone: 0/,�___ 71�ess�l E-mail:
Address City: State: Zip Code
Proposed Scope of Work: ��(
REV 2015 Page 6 of 9
/ COMMERCIAL APPLICATION
PERMIT SUBMITTAL
Department of Community& Economic Development
City of Arlington • 18204 59th Ave NE•Arlington, WA 98223 • Phone (360)403-3551
j) Show the location of all new walls,doors,windows, etc.
k) Provide details and assembly numbers for any fire resistive assemblies.
1) Indicate on the plans all rated walls,doors,windows and penetrations.
m) Provide a legend that distinguishes existing walls,walls to be removed and new walls
3 ❑ Reflected Ceiling Plan
a) Plan view 1/8"minimum scale. Details a minimum'/-inch scale.
b) Provide ceiling construction details.
c) Provide suspended ceiling details complying with IBC 803.9.1.1.Show seismic bracing details.
d) Show the location of all emergency lighting and exit signage.
e) Detail the seismic bracing of the fixtures.
f) Include a lighting fixture schedule.
4. ❑ Framing Plan
a) Specify the size,spacing,span and wood species or metal gage for all stud walls.
b) Indicate all wall, beam and floor connections.
c) Detail the seismic bracing for all walls.
d) Include a stair section showing rise, run, landings, headroom, handrail and guardrail dimensions.
5. ❑ Storage Racks(if applicable)
a) Structural calculations are required for seismic bracing of storage racks eight feet or greater in height.
b) Eight feet or less,show a positive connection to floor or walls.
NOTE: High pile storage shall meet the requirements of current International Building and Fire Codes.
C. ❑ SPECIAL INSPECTION
1. Where special inspection is required by IBC 1704,the registered design professional in responsible charge shall prepare
a special inspection program that will be submitted to the City of Arlington and approved prior to issuance of the building
permit to comply with IBC 106.1.
D. ❑ WASHINGTON STATE ENERGY CODE
1. One(1)completed Washington State Non-Residential Energy Code Envelope Summary forms
E. OCCUPANT'S STATEMENT OF INTENDED USE
1. The Occupant's Statement of Intended Use form shall be completely filled out and may require the submittal of a
Hazardous Materials inventory Statement(HMIS). Contact the Arlington
REV 2015 Page 4 of 9
G�'Y Of
COMMERCIAL APPLICATION
�•,���� PERMIT SUBMITTAL
Department of Community&Economic Development
City of Arlington • 18204 59th Ave NE•Arlington, WA 98223 • Phone(360)403-3551
A. FEES DUE AT TIME OF PERMIT ISSUANCE
B. CODES
The City of Arlington currently enforces the following:
International Codes
1. 2015 International Building Code(IBC)
2. 2015 International Residential Code(IRC)
3. 2015 International Mechanical Code(IMC)
4. 2015 International Fuel Gas Code(IFGC)
5. 2015 International Fire Code(IFC)
6. 2015 International Plumbing Code(IPC)
7. 2015 International Property Maintenance Code(IPMC)
8. 2015 International Existing Property Code(IEBC)
9. 2015 Washington State Energy Code(WESC)
10. 2009 Accessible&Usable Buildings and Facilities(ICC/ANSI 1417.1)
Washington State Amendments
1. WAC 51-50 Washington State Building Code
2. WAC 51-51 Washington State Residential Code
3. WAC 51-52 Washington State Mechanical Code
4. WAC 51-54 Washington State Fire Code
5. WAC 51-56&51-57 Washington State Plumbing Code and Standards
6. WAC 51-11 Washington State Energy Code
7. WAC 296-46B Electrical Safety Standards,Administration, and Installation
C. CITY OF ARLINGTON DESIGN REQUIREMENTS
Design Wind Speed: 85 miles per hour(Exposure C)
Ground Snow Load: 25 pounds per square foot
Seismic Zone: D2
Rainfall: 2 inches per hour for roof drainage design.
Frost Line Depth: 12 inches
Soil Bearing Capacity: 1,500 psf unless a Geo-Technical Report is provided. (IBC Table 1804.2&IRC R401.4.1)
D. PLANS AND DRAWINGS
Submit two(2)complete sets of drawings and plans. Drawings and plans must be submitted on minimum 18"X 24", or maximum
30"X 42"paper.All sheets are to be the same size and sequentially labeled. Plans are required to be clearly legible,with scaled
dimensions, in indelible ink, blue line, or other professional media Plans will not be accepted that are marked preliminary or not
for construction,that have red lines, cut and paste details or those that have been altered after the design professional has
signed the plans.
Please Note:A separate submittal of plans is required for each building or structure.
REV 2015 Page 2 of 9
'VY
COMMERCIAL APPLICATION
PERMIT SUBMITTAL
�ilNG1 Department of Community&Economic Development
City of Arlington • 18204 59th Ave NE •Arlington, WA 98223 • Phone (360)403-3551
Project Name/Tenant �
Site Address NO L<k&M A// �&2 Bldg/Unit/Suite
IBC Construction Type�X IBC Occupancy Type 0
Description of Use/Aw,;2A/
Building Square Footage 7 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.
Statement of Special Inspection
REV 2015 Page 7 of 9
Y r4
COMMERCIAL APPLICATION
PERMIT SUBMITTAL
Department of Community& Economic Development
City of Arlington • 18204 59th Ave NE•Arlington,WA 98223 • Phone(360)403-3551
The special inspection functions are considered to be in addition to the normal inspections performed by the City and the contractor is
responsible for contacting the City to schedule regular inspections. No concrete shall be poured or other work covered until approved
by the City Inspector.
Building Division:
The Building Division shall review any revisions and addenda.Approved copies will be given to the contractor to maintain as part of the
approved plan set.
The City Inspector will monitor the special inspection functions for compliance with the agreement and the approved plans.
The City Inspector shall be responsible for approving various stages of construction to be covered and work to proceed.
Design Professionals:
The architect and engineer will clearly indicate on the plans and specifications for the specific types of special inspection required,and
shall include a schedule for inspection and testing.
The architect and engineer will coordinate their revisions and addenda process in such a way as to insure all required City approvals
are obtained, prior to work shown on the revisions being performed.
Owner:
The project owner,or the architect or engineer acting as the owners agent,shall employ the special inspector or agency.
ENFORCEMENT:
A failure of the special inspector or firm to perform in keeping the requirements of the IBC,the approved plans and this document may
void this agreement and the Building Officials approval of the special inspector. In such case a new special inspector and/or firm would
need to be proposed for approval.A failure of the design and/or construction parties to perform in accordance with this agreement may
result in a STOP WORK notice being posted on the project, until nonconforming items have been resolved.
ACKNOWLEDGEMENTS
I have read and agree to comply with the terms and conditions of this agreement.
Owner: Date:
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
Print Applicants Name Date
FOR STAFF USE ONLY
Permit# Accepted By Amount Received Receipt# Date Received
REV 2015 Page 9 of 9
c
CITY OF ARLINGTON
238 N. OLYMPIC AVE - ARLINGTON, WA. 98223
PHONE; (360) 403-3551
BUILDING PERMIT
Address:2430 State Route 530 Permit#:2051
Parcel#:31050800300300 Valuation:2000000.00
OWNER APPLICANT CONTRACTOR
Name:PILOT TRAVEL CENTERS LLC Name:Pilot Travel Centers,LLC Name:Pilot Travel Centers,LLC
Address:5508 LONAS ROAD Address:5508 Lonas Road Address:5508 Lonas Road
City,State Zip:KNOXVILLE,TN 37909 City,State Zip:Knoxville,TN 37909 City,State Zip:Knoxville,TN 37909
Phone: Phone: 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: Commercial New CODE YEAR: 2015
STORIES: CONST.TYPE:
DWELLING UNITS: O OCC GROUP:
BUILDINGS: Vehicle Fuel Canopy 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 IOARCI 10.
SALES TAX NO' •Sales tax relating to construction and construction materials in the City of Arlington must be repo I your tax return form
and de f ton#31
X//71 g
ignature Print Name Date Robgg.FTirfy Date
CONDITIONS
Adhere to approved plans.
THIS PERMIT AUTHORIZS ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION
ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION.
PERMIT FEES
Date Description Fee Amount
7/13/2018 Building Permit Fee $2,283.58
7/13/2018 Building Plan Review Fee $1,484.33
7/13/2018 Processing/Technology Fee $25.00
7/13/2018 State Surcharge-Commercial $25.00
Total Due: $3,817.91
Total Payment: $0.00
Balance Due: $3,817.91
CALL FOR INSPECTIONS
BUILDING(360)403-3417
When calling for an inspection please leave the following information:
Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon
Permit#: 2051
Permit Date: 07/12/18
Permit Type: COMMERCIAL BUILDING
Project Name: Pilot Travel Center#1103
Applicant Name: Pilot Travel Centers, LLC
Applicant Address: 5508 Lonas Road
Applicant, City, State, Zip: Knoxville, TN 37909
Contact: Ross Shaver
Phone:
Email: ross.shaver@pilottravelcenters.com
Scope of Work: Vehicle Fuel Canopy
Valuation: 2000000.00
Square Feet: 0
Number of Stories: 1
Construction Type:
Occupancy Group:
ID Code:
Permit Issued: 07/17/2018
Permit Expires:
Form Permit Type:
Status: COMPLETE
Assigned To: Launa Black
Property
Parcel# Address Legal Description Owner Name Owner Phone Zoning
31050800300300 2430 STATE ROUTE 530 PILOT TRAVEL 910 Undeveloped
CENTERS LLC (Vacant)Land
Contractors
Contractor Primary Contact Phone Address Contractor Type License License
Pilot Travel Centers,LLC 5508 Lonas Road
Inspections
Date Inspection Type Description Scheduled Date Completed Date Inspector Status
07/27/2018 Inspection Canopy pier footings 07/27/2018 BUILDING Approved
complete.KO
Fees
Fee Description Notes Amount
Building Permit Table 4-1 $2,283.58
Building Plan Review Table 4-2 $1,484.33
Processing/Technology $25.00
State Surcharge-Commercial Commercial Only $25.00
Total $3,817.91
Attached Letters
Date Letter Description
07/13/2018 Building Permit
Payments
Date Paid By Description Payment Type Accepted By Amount
07/19/2018 Pilot Flying J Check#3306008 Kristin Foster $3,817.91
Outstanding Balance $0.00
Notes
Date Note Created By:
07/12/2018 Reviewed by SafeBuilt Launa Black
07/12/2018 Plans are included in the building set BLD-1808 Launa Black
07/12/2018 Reviewed by SafeBuilt Launa Black
07/12/2018 Plans are in the building set BLD-1808 Launa Black
Uploaded Files
Date File Name
01/02/2020 6044078-2051 2052 7-27-18IC.pdf
07/17/2018 3722458-2051 Issued Permit.pdf
07/12/2018 3708601-2051 Application.pdf
Permit#2051
Address Payment Info
Address 2430 STATE ROUTE 530 Receipt# 1207305
City ARLINGTON Date 7/19/2018
State WA Paid By Pilot Flying J
Zip 98223 Description
Payment Type Check#3306008
Accepted By Kristin Foster
Fees Paid
Fee Fee Description Factor Total Fee Amount
Amount Paid
Building Permit Fee 322.10.00.00 2283.58 2,283.58 2,283.58
Building Plan Review Fee 345.83.00.00 1484.33 1,484.33 1,484.33
Processing/Technology Fee 341.43.00.02 0 25.00 25.00
State Surcharge-Commercial 386.00.01.00 or 25.00 25.00
Total Payment:3,817.91