HomeMy WebLinkAbout18305 Cedarbough Loop_BLD87443_2025` NOTICE and Inspection Ret._rt
Address
vi (j
Contractor
I
i
Owner
Requested by
TYPE OF INSPECTION REQUESTED
BLDG: Pmt. No. ❑ MECH: Pmt. No.
❑ PLBG: Pmt. No.
Footing ❑ Framing
Foundation ❑ Drywall Nailing ❑ Final
❑ Concrete Slab ❑ Rough -In
❑ Fireplace and Chimney ❑ Furnace ❑ Other
El APPROVAL ❑ PARTIAL APPROVAL
❑ VIOLATION ❑ CORRECTION REQUIRED
❑ Corrections listed below MUST BE MADE before work can be approved.
❑ APPROVED FOR OCCUPANCY subject to certificate of occupancy.
❑ Work listed below has been Inspected and approved.
❑ Please contact inspector and arrange for appointment.
❑ Was not able to perform inspection.
❑ CAUL 435.5785 FOR REiNSPECTION — 24 hour notice required.
Inspector I, /..41 Irr 1 � " •'' • . t: j am.. Date
I was present during this inspection.
city o� ItL1 ING"I'llN
NOTICE and Inspection Report
Address
r�
Contractor
Owner
Requested by
PE OF INSPECTION REQUESTED
❑ BLDG: Pmt. No. �� ❑ MECH: Pmt. No.
❑ PLBG: Pmt. No.
❑ Footing Framing
❑ Foundation LJ Drywall Nailing ❑ Final
❑ Concrete Slab ❑ Rough -In
❑ Fireplace and Chimney ❑ Furnace ❑ Other
C .APPROVAL ❑ PARTIAL APPROVAL
'❑ VIOLATION ❑ CORRECTION REQUIRED
❑ Corrections listed below MUST BE MADE before work can be approved
APPROVED FOR OCCUPANCY subject to certificate of occupancy.
❑ Work listed below has been inspected and approved.
❑ Please contact inspector and arrange for appointment.
❑ Was not able to perform Inspection.
❑ CALL 435.5785;FORrREINSPECTION — 24 hour notice required.
Inspector Date _
I was present during this Inspection.
Permit ✓
a'
Date Called
Time Called
By
C�ly q "'L-IN1:TION
t.
NOTICE ana Mspection Report
Address����
Contractor
}
Owner
Requested by 1
TYPE OF INSPECTION REQUESTED
❑
Setback
❑
Reroof
❑ Insulation
❑
Plumb GW
❑
Roof Diaphragm
.''Gas Piping
❑
Footing
❑
Framing
❑ Woodstove
❑
Foundation
❑
Drywall Nailing
❑ Final
❑
Concrete Slab
❑
Rough -In Plumbing
❑ Reinspection
❑
Shear Wall
❑
Furnace
❑ Other
APPROVAL
❑ PARTIAL
APPROVAL
❑ VIOLATION
❑ CORRECTION REQUIRED
❑ Cor clions listed below MUST BE MADE before work can be approved.
Work listed below has been inspected and approved.
❑ Please contact inspector and arrange for appointment.
❑ Was not able to pert m inspection.
❑ CALL 435o578 FOR REINSPECTION — 24 hour notice required.
Inspector
Date
I was present during this inspection.
5 h�y��o�rn
❑ COMBINATION
CITY OF ARLINGTON
CONSTRUCTION
PERMIT
❑ BUILDING n MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO.00443
OWNER MAIL ADDRESS CITY ZIP PHONE
Steve Olivares
ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE
GENERAL CONTRACTOR
MAIL ADDRESS
CITY ZIP PHONE
LICENSE N
Cozy Heating Inc. 20221 67th Ave
NE Arlington, WA 98223 435-4904
COZYHI*122MM
MECHANICAL CONTRACTOR
MAIL ADDRESS
CITY ZIP PHONE
LICENSE
SAME
PLUMBING CONTRACTOR
MAIL ADDRESS
CITY ZIP PHONE
LICENSE
SAME
CLASS OF WORK
❑ NEW f] ADDITION
❑ ALTERATION ❑ REPAIR
❑ DEMOLITION []BUILDING RELOCATION
VALUATION OF WORK
s2,000.00
DESCRIBE WORK
(_ate D4rocs F'i�rnan�
PRUPOSt D USt Of B'UILDING
Residential
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA-
AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI-
SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK
WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT. THE
GRANTING OFA PERMIT DOES NOT PRESUME TO GIVE AUTHORITYTO
VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR
LOCAL LAW REGULATING CONSTRUCTION OFTHE PERFORMANCE OF
CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE.
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE
X
LLUAL DESCRIPTION Of PROPERTY )SHOWN BELOW OR ATTACH FOUR COPIES)
LOT D-4 BLOCK OF Woodlands Sector I
TAX ID NUMBER
7385^004-060-0009
jOB ADDRLSS
18305 Cedarbough Loop
(OFFICE USE ONLY)
PLUMBING
MECHANICAL
NO,
TYPE OF FIXTURE
FEE
NO.
TYPE OF EQUIPMENT
FEE
WATER CLOSET (TOILET)
AIR COND UNITS - H.P. EA
BAIHIUB
REFRIGERATION UNITS -H P. EA.
LAVATORY (WASH BASIN)
BOILERS - H P EA
SHOWER
GAS FIRED A C UNITS - TONNAGE EA
KI ICHEN SINK & DISP.
1
FORCED AIR SYSTEMS — B T U MEA
9
00
DISHWASHER
WALL HEATERS — B T U M
LAUNDRY TRAY
UNIT HEATERS — B.T U M
CLOIHESWASHER
EVAPORATIVECOOLERS
WAIER HEATER
CLOTHES DRYERS
URINAL
VENTILATICN FAN
DRINKING FOUN IAIN
RANGE HOOD COMMERCIAL
FLOOR DRAIN
AIR HANDLING UNIT — CPM
VACUUM BREAKERS
STOVE
ROOF DRAINS - RAINLEADERS
METAL FIREPLACE & CHIMNEY
SINK (SERVICE — BAR, ETC)
WATER HEATER
GAS PIPING
SUB TOTAL ;
SUBTOTAL $
12
00
PERMIT ;
PERMIT $
TOTAL FEE ;
TOTAL FEE ;
SIDE YARD SE I BACK
STREET SETBACK
REAR YARD SETBACK
PLAN CHECK NUMBER
-
PLAN
FEE
CHECK FEE
RECEIPT NO
USE ZONE
LOT AREA
VACANT SITE
❑ YES ❑ NO
FEES
VALUATION
FEE
PLAN CHECKING NG
TYPE OF CONST
OCCUPANCY GROUP
NO. OF DWELLING UNITS
BUILDING
$
SIZE OF BLDG
NO OF STORIES
MAX.000. LOAD
PLUMBING
FIRE SPRINKLERS REQUIRED
❑ YES ❑ NO
MECHANICAL
2.7
OC
COMMENTS
r�
STATE BLDG. CODE
ENERGY CODE SURCHARGE
PENALTY
U.B C.
SEC,303(a)
WATER/SEWER FEES
TOTAL
27
0
PERMIT VALIDATION
WHEN PROPS/ IDATED (IN THIS SPACE) THIS IS YOUR PERMIT & RECEIPT
Q I Ck 1) 7 7 '17 o f
rLJ r
f
cc: ASSESSOR, APPLICANT, TREASURER, BLDG DEPT
CITY OF ARLINGTON
CONSTRUCTION
PERMIT
❑ A COMBINATION ❑ BUILDING P' MECHANICAL ❑ PLUMBING
5AP--j
Nr,CONT RAC70R
MAIL AUUKt SS
❑ SIGN
PERMIT NO. 443
CITY ZIP PHONE
CLASS OF WORK
❑ NLW OADDITION Cl ALTERATION Cl REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION
VALUATION OF WORK
$
DESCRIBE WORK
P RCIPS )5k ls'11<F Cli ii�'n �r �
Lc %L uL.c% Klr I tuN lrA rxVrtK J T (]IMMN t LLOW OR ATTACH FOUR COPIE's)
LOT
D BLOC1 rr OF
TAX ID NUMBER
IUD AUUKLSS
1S3d�_ - C
(OFFICE USE ONLY)
PLUMBING
NO. TYPE OF FIXTURE FEE
WATER CLOSET (TOILLI)
BAIIIIUB
LAVATORY (WASH BASIN)
SHOWER
KI ICIILN SINK & DISP.
DISHWASHER
LAUNDRYIRAY
CLOIHLSWASHLR
WATER HEATER
URINAL
DRINKING FOUNIAIN
FLOOR DRAIN
VACUUM BREAKERS
ROOF DRAINS - RAINLEADERS
SINK (SERVICE - BAR, ETC.)
SUBTOTAL S
PERMIT ;
TOTAL FEE S
SIUL YARD SE I BACK ISTRLEISETBACK REAR YARD SETBACK
TYPL OF CONST
SIZE Of' BLDG.
COMMENTS
OCCUPANCY GROUP
NO. OF STORIES
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA-
TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI-
SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK
WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT. THE
GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO
VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR
LOCAL LAW REGULATING CONSTRUCTION OFTHE PERFORMANCE OF
CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE.
SiGNAT �OF CONTRACfORCIRAUTHORIZED AGENT DATE
MECHANICAL
NO. TYPE OF EQUIPMENT FEE
AIR COND. UNITS - H.P. EA.
REFRIGERATION UNITS - H.P. EA.
BOILERS - H.P. EA
GAS FIRED A.C. UNITS - TONNAGE EA.
FORCED AIR SYSTEMS - B.T.U. EA
WALL HEATERS - B.T.U. M
UNI1 HEATERS - B.T-U. M
EVAPORAI IVE COOLERS
CLOTHES DRYERS
VENTILATION FAN
RANGE HOOD COMMERCIAL
AIR HANDLING UNIT - CPM
STOVE
METAL FIREPLACE & CHIMNEY
WATER HEATER
GAS PIPING
SUBTOTAL S
PERMIT $
TOTALFEE $
PLAN CHECK NUMBER PLAN CHECK FEE
^
I' FEE I RECEIPT NO.
VACANT SITE
❑ YES ❑ NO
FEES
VALUATION
FEE
NO. OF DWELLING UNITS
PLAN CHECKING VG
BUILDING
S
MAX. OCC. LOAD
PLUMBING
FIRE SPRINKLERS REQUIRED
❑ YES ❑ NO
MECHANICAL
r
STATE BLDG. CODE
ENERGY CODE SURCHARGE
PENALTY
U.B.C.
SEC. 303(a)
WATER/SEWER FEES
TOTAL
PERMIT VALIDATION
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PFRMfT ERECEIPT
PAID — CR � 's BY q
cc: ASSESSOR, APPLICANT, TREASURER, BLDG. DEPT. I BUILDINGOFFICIAL DATE
RECORDS COPY
OV City q AItLI►N' GTO N PERM`T APPLICATION
fj�i 230 N. OLYMPIC(AV 4 5RLINGTr WA 98223JUL `
5785
ERCIAL, RESIDENTIAL, MECHANICAL, PLUMBING, GRADING
FIG
cur
Tax Accpunt Numbe 0 C)�� '
Job Site Address xe'��`����%�� City
Applicant Name � 't f �' % �: tffll"r� Phone 35' 9 • - 7-
Mailing Address % % ,7 fa' N � City /G' rCi Zip 7 g _7 r 3
Contractor Name ,!' .['/1✓/. /)? r Z Z I } A.r License #
Address o2 7 to -5J City AA` i� j 4 ../ Zip , Z� Z '3 Phone l3.57` .3 7 Z
Architect/Engineer
Address
TYPE OF PROJECT
City
Sewage Disposal Right -of -Way Width
LOCATIONAL INFORMATION: SEC TWP
Plat Name/Short Plat No./Segregation No. 6-1�1&
Lot/Parcel # Block #
Is the average slope of the property in excess of 25%? Yes
License #
Zip Phone
Culvert Permit No.
RGE 16th
'kak-
No /e
This structure will be used for the following purpose``£'`"
Other buildings on this property
NEI
Lot Size I C%
Has construction started? Yes No
OWNER/AGENT SIGNATURE DATE / J30 —97
NOTICE: Front Yard Setbacks. Curbs, Sidewalk Edge, Edge of Street pavement is not necessarily your front property line. In the case
where your setback will be measured from the front property line, be certain that you are measuring from the actual front property line and
that your plot plan depicts this. In the event your setback will be measured from a private access easement, the edge of the improved road
is not necessarily your front property line. Be certain that you are measuring from the edge of the actual easement and that your plot plan
depicts this.
ACKNOWLEDGED
------------------------OFFICE USE ONLY BELOW THIS LINE ------------------------
PERMIT CONDITIONS ... I
ZONING: —
SETBACKS:
Front
Side
Rear
Basic Plan #
SPECIAL CONDITIONS ...
SANITATION
Max Lot Cover
Other Covenants
ON SITE LETTER
ENV HEALTH SEWER
ACCESS
RSBP
ESMT
RSME
ADDRESS
J_
PLBG
CULVERT
MBHM
�_
_ AFF/BOND
MOVE
GRADING
INSP
CU
FL ZN—
SEPA
SH LN_
OCD
LS
STD B LA
SP _
5 ACRE_
LOTS _
20 ACRE
OCP
FML BLA
SP VAR_
% Max Bldg. Height
DRAIN
CN R/R
SLIDE
SLOPE
SEPA
_ OTHER
OTHER
PLAT
SU
PUBLIC WORKS
TRAFF_
RD IMP
CMBP
CMME
_ SITE PLAN
FIRE
REZONE
VA
ft
PLUMBING PERMIT
F3_1
FIXTURES
No.
Water Closets
--
Bath Tubs
2`
Shower 41aShs
Wash Basins
Sinks
`?
Dish Washing Machine
Hot Water Tanks
/
Drains
Laundry Washers
Laundry Trays
Urinals
Drinking Fountains
Rain Leaders
Sumps
Vacuum Breakers
Gas Piping
Side Sewers
Water Service Line
Misc
Total Fixtures !
Permit Fee
Total Due $
Related Bldg. Permit #
MECHANICAL PERMIT (N07 FOi. ,AOBILE HOMES) i
UNIT TYPE: _
Electric Oil Gas LPr~ 0lar
UNIT SIZE: BTU's KW
No. FEE
FOR THE INST. OR RELOC. OF
Forced Air Systems
Fuel Storage Tanks
Heat Pumps
Wood Stove
Fireplace Insert
—0— Clearance Fireplace
GRADING/FILL INFORMATION
No. of cubic yards:
To be removed from site_
To be imported to site
Permit Fee _
Total Due $
IF MORE THAN ONE BUILDING, SUBMIT SEPARATE APPLICATION FOR
EACH STRUCTURE. A SEPARATE BUILDING
PERMIT MUST BE ISSUED
FOR EACH BUILDING.
F61
BUILDING DIMENSIONS:
MAIN FLOOR
MAIN FLOOR SQ. FT.
SECOND FLOOR
SECOND FLOOR SQ. FT.
THIRD FLOOR
THIRD FLOOR SQ. FT.
FOURTH FLOOR
FOURTH FLOOR SQ. FT.
MEZZANINE
MEZZANINE SQ. FT.
J �
BASEMENT
BASEMENT SQ. FT.
GARAGE
GARAGE SQ. FT.
�� 1
CARPORT
CARPORT SQ. FT.
�I
DECK
DECK SQ. FT_
NUMBER OF FIREPLACES
TOTAL SQ. FT.
FOR OFFICE USE ONLY
ROUTING SCHEDULE:]
Bldg: sent
rcv'd
Valuation
Site Plan: sent
rcv'd
Plan Check
% —2_ rcp
San: sent
rcv'd
Permit Fee
Env. Hlth: sent
rcv'd
Penalty Fee
Eng: sent
rcv'd
Plumbing Fee
FM: sent
rcv'd
Mechanical Fee
Env. Cklt Fee
TOTAL DUE: