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Home My WebLink About6922 Cedarbough Loop_BLD025063_2025dN Permit No. City of Arlington NOTICE rend Inspew;fion Report Date Called' , Z. Address Time Contractor/Own B Requested b E! TYPE OF •REQUESTED ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm XGas Piping ❑ Footing ❑ Framing ❑ Woodstove ❑ Foundation ❑ Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough -In Plumbing ❑ Reinspection ❑ Shear Wall ❑ Furnace / Other�'di _ Q' APPROVAL ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ Work listed below has been inspected and approved. ❑ CALL 435-0724 FOR REINSPECTION - 24 hour notice required. C4/ Inspector _ r;,.+., r Date ' { INSPECTION REPORT .VN C Q Permit No.��' 06 3 Lot #: ,+ T Address: 0 1 ,j �. Contractor: q' O Owner: _f- IN O� Date: y ,APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUESTED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ Please contact inspector. ❑ Was not able to perform inspection. ❑ CALL 435-0674 FOR RE -INSPECTION - 24 hour notice required. Inspector: ❑ Under -floor ❑ Footing ❑ Foundation ❑ Mechanical ❑ Wood Stove ❑ Masonry ❑ Other: la� Date: f PE OF INSIF'tCTION REQUESTED ❑ Framing ❑ Drywall, Nailing ❑ Shear Nailing ❑ Grid ❑ Rough -in ❑ Drainage ❑ Gas Piping ❑ Consultation ❑ Groundwork ❑ Struct. Slab A Final ❑ Insulation INSPECTION REPORT N G P, Permit No.: Lot #: o S Address: 36. � Contractor: -ys, �0 Owner: _ �A IIN G Date: C� ❑ APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION 4CORRECTION REQUESTED ❑ Corrections listed below MUST BE MADE before work can be approved ❑ Please contact inspector. ❑ Was not able to perform inspection. ❑ CALL 435-0674 FOR RE -INSPECTION - 24 hour notice required. Inspector: + Date: /tYPE OF P&ECTION REQUESTEDuo tf ❑ Under -floor ❑ Framing Gas Piping ElFooting ❑ Drywall, Nailing CJ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough -in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: INSPECTION REPORT � 0. 3 Permit No.: Q.,k �,) L-U Lot #: Address: i • r� Contractor: 1 g fl Owner: I N G Date: ` ❑ APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION CORRECTION REQUESTED Corrections listed below MUST BE MADE before work can be approved ❑ Please contact inspector. ❑ Was not able to perform inspection. ❑ CALL 435-0674 FOR RE -INSPECTION - 24 hour notice required. ❑ Footing ❑ Foundation ❑ Mechanical ❑ Wood Stove ❑ Masonry ❑ Other: ❑ Drywall, Nailing ❑ Shear Nailing ❑ Grid ❑ Rough -in ❑ Drainage LI Consultation ❑ Groundwork ❑ Struct. Slab ❑ Final ❑ Insulation _fir city o�A ItLINGFr0N NO 1C�, Ltd Inspection Report E Address Contractor — Owner Requested by — - TYPE OF INSPECTION REQUESTED ❑ BLDG: Pmt. No. ❑ MECH: Pmt. No. ❑ PLBG: Pmt. No. ❑ Footing ❑ Framing ❑ Foundation ❑ Drywall Nailing �lnal ❑ Concrete Slab ❑ Rough -In ❑ Fireplace and Chimney ❑ Furnace ❑ Other APPROVAL ❑ PARTIAL APPROVAL VIOLATION ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ APPROVED FOR OCCUPANCY sUb)00t" 0=8Micaie 0"catepaney. ❑ Work listed below has been inspected and approved- ❑ Please contact inspector and arrange for appointment. ❑ Was not able to perform inspection. ❑ CALL 435-5785 FOR REINSPECTION — 24 hour notice required. f � f Inspector I was present dun t '/f / .2 -9 @ate s inspection. cagot INAISKLINGTON NOTICE and Inspection Report t.� ti Address Contractor Owner Requested by TYPE OF INSPECTION REQUESTED l BLDG: Pmt. No. ° �- ❑ MECH: Pmt. No. ❑ PLBG: Pmt. No. ❑ Footing Z.Framing ❑ Foundation ❑ Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough -In ❑ Fireplace and Chimney ❑ Furnace Other 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 FOR REINSPECTION — 24 hour notice required. Inspector to I was present during this inspection. I City o� it►ItLING,■ oIhi NOTICE and Inspection Report Address L Contractor = Owner Requested by TYPE OF INSPECTION REQUESTED 01-BLDG: Pmt. No , ❑ MECH: Pmt. No. 14 PLBG: Pant. No. A❑ Footing ❑ Framing D Foundation El Drywall Nailing ❑ Final ❑ Concrete Slab ough-In ❑ Fireplace and Chimney ❑ Furnace ❑ Other EJ 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 FOR REINSPECTION — 24 hour notice required. Inspector to I was present during this inspection. oaq q mat It1d:NG,r11N NOTICE and Inspection Report Address Contractor Owner Requested by TYPE OF INSPECTION REQUESTED ❑ BLDG: Pmt. No. ❑ MECH: Pmt. No. ❑ PLBG: Pmt. No. ❑,Footing ❑ Framing i Foundation ❑ Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough -In ❑ Fireplace and Chimney ❑ Furnace ❑ Other ❑ 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 FOR REINSPECTION — 24 hour notice required. Inspector Date I was present during this inspection. City od thItLINoi.rr40N NOTICE and Inspection Report �ff:iG l i �j Address i Contractoi Owner i n 7 Requested by i TYPE OF INSPECTION REQUESTED X BLDG: Pmt. No. ❑ MECH: Pmt. No. ❑ PLBG: Pmt. No. _>!�_gooting ❑ Framing ❑ Foundation ❑ Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough -In ❑ Fireplace and Chimney ❑ Furnace ❑ Other - 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 FOR REINSPECTION — 24 hour notice required. inspector - to I was present during this inspection. MI 2�52, oo 254,00 25Z.e>v �o t a0(�Ire e4-) bei4- 251 .Sv\ 2s2 v� OA 4 I?O.82 ,PvT T-1 Ru SGAL E 1',= 20 LOT C-so T+1 E 0001:�)L4,,OR S I O+Iom I Ss w CC-)UJTY kAl CITY CaF k'eL►U<; I OU ti M ai laY 3 �.q ' 1 O V/c � `vA LOT LIVE 254.�n w 253, Sa � CL�1 tZ-�-IUr-�► ES C��2 i� 34�.W12 G 4 St. Clair Homes P.O. Box 2267 Lynwood, WA 98020 June 29, 1987 l ,Iff, of : le L I N G"I'41 N CITY HALL O THIRD & OLYMPIC AVENUE ARLINGTON, WA 98223 ❑ (206) 4390? 5785 RE: Lot C-50 Woodlands Reduction of rear yard setback After review of the above noted lot and the request to reduce the rear setback , as well as the report from the Code Enforcement Officer. I hereby approve the reduction as noted on the attached plot plan map. If you should have any questions, please contact me at the above noted address or phone Cordially, 16�0hn4Tou�relle City Planner Note: In City Supervisor Thom Myers Absence, Mr. Latourelle is acting in his place. El City of Arlington Re: Lot C-50 Woodlands Sir: June 11, 1987 Request adjustment of rear yard setback to that shown on plot plan. The lot is very shallow and the dwelling is scaled to minimum. Thank you. St Via' o es Corp Wm. L. Milwicz e.*eo St-t64_4cs C,-1 8 0 7 S 66 48' ?0' F 7 1320.32 R C., BOVEE 1M 161h CORNER FOUND IRON PIPE s C I T1f OF ARL I P4CG-IF OhI COhJS-IF FRUCT I Oh! PERM I T PE Ft I T MC3 _ c 4a2-506 3 ►ner: ENGBERT, BARRY 6922 S CEDARBOUGH LP RD ARLINGTON 98223 slue of Work: Tax ID: 007385-003-050-00 Phone: 360.403.7457 escribe Work: CONVERT ELECTRIC TO GAS WATER HEATER roposed Use: SFR ,egal Description: fob Address: 6922 S CEDARBOUGH LP RD antractor's Name Type Address License* AST WATER HEATER CO. NEC 12601 132ND AVE WHC052DF P E R M I T F E E S Equipment and Fixtures Number --Fee--- Total Charge WATER HEATER 1 515.00 $15.00 GAS PIPING 1-4 OUTLETS 1 S6.00 $6.00 S U B T O T A L...... 521.00 TOTALS Equipment Mech Permit TOTAL FEE ................. PAYMENTS .................. TOTAL DUE ................. DATE RECEIPT P A I D MAY 2 8 2002 Fee $21. 00 $24. 00 $45. 00 $0. 00 $45. 00 41 GRATURE: HEREBY CERTIF THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND COR- RECT ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL 5E nLIED WITH WHETHER SPEC E E 40*1 BU G OFFIC AL. Caq of ARLINGTON PERMIT APPLICATION 230 N. OLYMPIC AVE., ARLINGTON 98223 (206) 435-5785 COMMERCIAL, RESIDENTIAL, MECHANICAL, PLUMBING, GRADING f Tax Account Number 39 I — 003 050 — 000'l Job Site Address BC) +4 L-!2v City f +®I ) —rbL2 Applicant Name G — Phone Mailing Address City t-s-)(C-)tZ'71� Zip Contractor Name fit= License # Sj C *k1 CI 1 Z F 13- Address IQo& EaKo&-')pS SF City E12)ADQ175 ZipCJ-�t� Phone :;3:!5j--�% t Architect/Engineer License # Address City Zip Phone TYPE OF PROJECT 21 Sewage Disposal Right -of -Way Width Culvert Permit No. LOCATIONAL INFORMATION: SEC TWP RGE 16th Plat Name/Short Plat No./Segregation No. Lot/Parcel # G SLR Block # Lot Size Is the average slope of the property in excess of 25%? Yes No k""' Has construction started? Yes No This structure will be used for the following purpose )RjLFLL-i Other buildings on this property OWNER / AGENT SIGNATU'' -EL-v-) L c DATE 61)115,z NOTICE: Front Yard Setbacks. C wa dge, 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. zt�z-- ACKNOWLEDGED ------------------------OFFICE USE ONLY BELOW THIS LINE ------------------------ PERMIT CONDITIONS .. . ZONING: �JMax Lot Cover % Max Bldg. Height ft SETBACKS: �� Front Side Rear 2-0 Basic Plan # Other Coven SPECIAL CONDITIONS .. . SANITATION ON SITE LETTER: ENV HEALTH SEWER ACCESS RSBP ESMT RSME ADDRESS PLBG CULVERT MBHM AFF/BOND MOVE GRADING INSP OCD LS STD B LA SP 5 ACRE LOTS 20 ACRE DRAIN CN R/R _ SLIDE SLOPE _ SEPA _ OTHER OTHER FLIBLII: WUHK5 TRAFF_ RD IMP CMBP CMME SITE PLAN FIRE OCP CU FL ZN FML BLA PLAT SEPA SH LN SP VAR SU— REZONE VA PLUMBING PERMIT F31 MECHANICAL PERMIT (NOT I _A MOBILE HOMES) F41 FIXTURES No. UNIT TYPE: Electric Oil Gas LPG_ Solar Water Closets Bath Tubs UNIT SIZE: BTU's KW Shower Baths Wash Basins f No. FEE Sinks FOR THE INST. OR RELOC. OF Dish Washing Machine Forced Air Systems Hot Water Tanks Fuel Storage Tanks Drains Heat Pumps Laundry Washers Wood Stove Laundry Trays Fireplace Insert Urinals —0— Clearance Fireplace Drinking Fountains Rain Leaders Sumps Vacuum Breakers Gas Piping Permit Fee Side Sewers Water Service Line Total Due $ Misc GRADING/FILL INFORMATION F51 Total Fixtures Permit Fee No. of cubic yards: Total Due $ To be removed from site Related Bldg. Permit # To be imported to site IF MORE THAN ONE BUILDING, SUBMIT SEPARATE APPLICATION FOR EACH STRUCTURE. A SEPARATE BUILDING PERMIT MUST BE ISSUED FOR EACH BUILDING. F6-1 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. BASEMENT BASEMENT SQ. FT. GARAGE GARAGE SQ. FT. CARPORT CARPORT SQ. FT. DECK DECK SQ. FT, NUMBER OF FIREPLACES i -iFOR OFFICE USE ROUTING SCHEDULE: Bldg: sent rcv'd �.""-"..`" Vtud: ➢. 36C��v Site Plan: sent rcv'd Plan Check 9" �J # Q of C& 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: CITY OF ARLINGTON CONSTRUCTION PERMIT ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO�j IWNER MAIL AD/DR{EESS� CITY ZIP PHONE (1 e_b? ��p 1 �� Sri L e2= j� ACHITLCT OR DESIGNER . MAIL ADDRESS CITY ZIP PHONE ,ENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N ILC14ANICAL CONTRACTOR MAIL ADDRESS CITY [Ir rnuNt L. n l I moo, ,I.0 ICEI�[�(AL_A 9 6G 3Cf eoo--� -fir ? -' LUMBINCG CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE IF LASS OF WORK NLW ❑ AUDITION ALTERATION ❑ REPAIR ❑ DEMOLI FION [:]BUILDING RELOCATION (ALUATION OF WORK )LSLRI'BE WORK -PUPO5 D US OF BUILDING AGAL DLS(-RIPI ION OF PROPLRTY ISHOWN BELOW OR ATTACH LU I BLOCK�OF r�� f TAX ID NUMBER JOB ADDRESS r (OFFICE USE ONLY) PLUMBING NO. TYPE OF FIXTURE WATER CLOSET (TOILET) BAIIIIUB LAVATORY (WASH BASINI SHOWER KI ICIILN SINK & DISP. DISHWASIIER LAUNURYIRAY CLOIHLS WASHLR WA1 LR HEATLR SILL Of SLUG COMMENTS NO. OF STORIL5 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 ANC? ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUMETO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF CONSTRUCTION. PERMIT EXPIRES I YEAR FROM DATE OF ISSUANCE. 5tGNA C NfRA OR.hUT110111ZfDAGENT DATE x_ MECHANICAL FEE NO, TYPE OF EQUIPMENT 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.0 MEA WALL HEATERS - B.T.0 M UNI1 HEATERS - B.T.U. M ME-V APORAI IVE COOLERS CLOTHESDRYERS VENTILATICN FAN RANGE• HOOD COMMERCIAL AIR HANDLING UNIT - CPM STOVE METAL FIREPLACE & CHIMNEY i WATER HEATER I GAS PIPING ARDSETBACK S ❑ NO DWELLING UNITS )CC. LOAD FIRE SPRINKLERS REQUIRE M YES n NO C F MAY 2 8 non CITY OF AR04GTOt' 0� _. l LAN CHECK NUMBER FEES PLAN CHECKING NG BU'LDING PLUMBING MECHANICAL STATE BLDG. CODE ENERGY CODE SURCHARGE PENALTY WATERISEWER FEES SUBTOTAL PERMIT TOTAL FEE L htt PLAN CHECK FEE FEE I RECEIPT NO. VALUATION I FEE S U.B.C. SEC. 303(a) TOTAL PERMIT VALIDATION WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT &RECEIPT PAID CR# , BY BUILDING OFFICIAL DATE cc: ASSESSOR, APPLICANT, TREASURER, BLDG. DEPT I RECORDS COPY CITY OF ARLINGTON CONSTRUCTION PERMIT _ i�s5 COMBINATION ❑ BUILDING MECHANICAL ❑ PLUMBING SIGN PERMIT NO. OWNER MAIL ADDRESS CITY ZIP PHONE David Kras:ki 6922 S Cedarbough.Loop Arlington 435-7958 ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LIC NSE N Kalaf's Service 14431 132nd St. NE Arlington 691 7245 KALAFSR101DN MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N CLASS OF WORK ❑ NEW E] ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLI TION ❑ BUILDING RELOCATION VALUATION OF WORK f 1000. DESCRIBE WORK gas fireplace insert PROPOSED USE OF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- SFR TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- LLUAL DES( RIPTION OF PROPERTY ISHOWN BELOW OR ATTACH FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK LOT C-51BLOCK OF Glenea le WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITYTO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR TAX ID NUMBER LOCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF CONS CTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE. SIGNATU E O CONTRACTOR OR AUT RIZED AGENT DATE JOB ADDRLSS � , 1. _ 6922 S Cedarb.ough_ Loop X 4-1- - V (OFFICE USE ONLY) MECHANICAL oi NO. TYPE OF FIXTURE FEE NO. TYPE OF EQUIPMENT FEE WATER CLOSET (TOILET) AIR COND UNITS - H P EA BAIIIHUB REFRIGERATION UNITS - H P EA LAVATORY (WASH BASIN) BOILERS - H P EA SHOWLR CAS FIRED A C UNITS - TONNAGE EA KI ICHEN SINK & DISP FORCED AIR SYSTEMS - B T U MEA DISHWASHER WALL HEATERS - B T U M LAUNDRY TRAY UNII HEATERS - B.T U M CLOTHES WASHLR EVAPORAI IVE COOLERS WAIERHEATLR CLOTHES DRYERS URINAL VENTILATICN FAN DRINKING FOUN I AIN RANGE FIOOD 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 PERMIT TOTAL FEE SIDE YARD SL I BACK STRELT SETBACK USE LONE LOT AREA TYPE OF CONST OCCUPANCY GROUP SIZE OF SLUG. NO OF STORIES COMMENTS mechanicalPENALTY only r ram. f $1 f REAR YARD SETBACK VACANT SITE ❑ YES ONO NO OF DWELLING UNITS MAX. (xC LOAD F IRE SPRINKLERS REQUIRED ❑ YES ❑ NO DATE RECEIVED FEES PLAN CHECKING NG BUTDING PLUMBING MECHANICAL STATE BLDG. CODE ENERGY CODE SURCHARGE WATER/SEWER FEES TOTAL SUBTOTAL PERMIT TOTAL FEE PLAN FEE f f f CHECK FEE RECEIPT NO VALUATION FEE f 24 50 U B C SEC 303(a) 24 rtLli PERMIT VALIDATION WHEN PROPERLY VALIDATED TIN THIS SPACE) THIS IS YOUR PER' IT & RECEIPT ACT 199.3 PAID I 5 CRiiZ;t, cc: ASSESSOR, APPLICANT, TREASURER, BLDG DEPT TE � _7 13 B�REC�;O hL DATE DS COPY a, 1 CITY OF ARLINGTON CONSTRUCTION PERMIT - 1 COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING 4 SIGN PERMIT N07 W OWNE -s //�'AlL ADDRESS �rg' C1IY ZIP PIIO/N/L/y JjI J �i '✓ F�/'- /� + lL� !r,,.�II�i L ARCHITECI OR DESIGNER J MAIL ADDRESS CITY Zip PHONE 1) L% GENE RALrLONJ RAC! R-, MAIL ADDRESS CITY ZI PMONG LIC tNSE I X MLCIIANICfNL CONTRACTOR MA L ADDRESS CITY 21P PIIONE LICENSE i u Ceti 3 j J PLUMBING CONTRACTOR L _ MAIL ADDRESS CITY 21P PHONE LICENSE G CLASS OF WgRK 1 ❑ NLW ADDITION - ❑ ALTERATION ❑ REPAIR ❑ DEMOLI IION []BUILDING RELOCATION VALUAFIOM40F WORK x X DESCRIBE WORK ? c� .CI C �Y r re �J.r]t`L 1 PRUPOSI O USE OF BUILDING - I HEREBY CERTIFY TI IAT I HAVE READ AND EXAMINED THIS APPLICA— TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI— SIGNS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED FIERIN 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 OF THE PERFORMANCE OF CO RUCTION. PERMIT EXPIRES 1 YEAR FROa• DATE OF ISSUANCE. SIGNq R Cf)NIRACTQR y R AUFIIDRt D AGENT i �D�� LLyh! Df 5( RlPI SUF! OF PRGIPL RTY ISFFOWN BELOW OR AT 1 AGI# FOUR COPIES) _ wl BLU(K OF C — a lfi.��`L` / TAX ID NUMBER FROM PROPERTY TAX STATEMENT IDB �UDR1.ss (()I�1%ICI? IISIi ONLY) � , I'LUMRIN(i ^+ _. _ ,-• -. •-_ NO. -� 'TYPE OF FIXTURE FEE - x's FIXTURTi5 VAI'1?R ( LOSf IT(TO11.01) S7.Ilt1 IAI'I I'I'111) - - �- —;7,OU FC11A_NICAL NO. _ TYPE OF EQUIPMENT FEE Vs FIXTURES IRCOND. UNITS - II.P. EA. , quip.list^ E_FRIGERATION UNITS - IT.P. EA. !quip. list•• ,AVATORY WASII BASIN $7.00 301LERS - H.P. EA. qui .list" _ I IOWER _ $7.00 3AS FIRED A.C. UNITS - TONNAGE EA. ui _ IFst• • �- ITCI IEN SINK & DISPOSAL $7.00 •ORCED AIR SYSTEMS - B.T.U. MEA S9.00 )ISIIWASI IER $7.00 WALL IIEATERS - B:I'.U. M $9.00 .AIINDRY TRAY S7A0 - - — _ NIT HEATERS - B: P.U. M ;9.00 '1,0'1'IIESWASIIER $7.00 3VAPORATIVECOOLERS _ V AIrRIII%ATER - 1RINAL � 57.00 E700 ---R-- - -�_ _LOTIIESDRYERS $6.50 ---- EN'TILATIONFAN S430 DRINKING FOUNTAIN _ T'f 00R DRAIN _ VACUUM BRIiAKERS itoolF DRAINS - RAINLRADERS SINK (SERVICE - BAR, L•'IV.) - -- --— _ --...._. --•AT-^SUB TOTAI, 11F.Rml-i 'IOIAI IT I", SIUL YARD SL I BALK SIRLLISLIBACK $7._00 $7.00 $7.00 ST00 $7.00 - REAR _ _ _ _ YARDSET8ACFL NGEHOOD COMMERCIAL $6.50 kiR IIANDLING UNIT - CPM - ;TOVE $6.50 METALFIREPLACE &CIIiMNEY $6.50 } WATER FIRATE R. $6,50 SAS PIPING •Lury l0 5=;7-00. addnl. = S.TS ca.) - 'Equipment list mull be r[t4idcd SUBTOTAL _ PERMIT ff •-a_. _ . ____-_ TOTALFEE _ e�%C DA7FRECENVO _ PLAN CHECK FEE FEE RECEIPT NO, USF AUNI LOT AREA VACANT SITE ❑ YES NO FEES VALUATION FEE PLAN CHECKING VG TYPE OF CONS OCCUPANCY GROUP NO, Of DWELLING UNITS BU'LDING % SIZE Of BLUG. NO.OF jam!! Ib! ! MAX. OCC. LOAD PLUMBING COMMENTS IIRE SPRINKLERS RLOU'IREII ❑ YES ❑ NO MECHANICAL STATE BLDG. CODE ENERGY CODE SURCHARGE PENALTY SU.B.C. SEC. )O)(+) WATER]SEWER FEES TOTAL PERMIT VALIDATION WHEN PROPERLY VALIDATED (IN THIS SPACEI THIS IS YOUR PERMIT & RECEIPT PAID CRII BY cc: ASSESSOR, APPLICANT, TREASURER, BLDG DEPT I BUILOINGOFFICIAL DATE RECORDS COPY