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Home My WebLink About615 Broadway St_BLD951887_2025C I TY OF A RU I NOYON CONSTRUCTION PERMIT PERMIT NO_ : Sn-1807 Owner: SAHAGUN, RUBEN 615 BROADAY ARLINGTON 98223 Value of Work: $1,800.00 Tax ID: Phone: 435-9433 Describe Work: RE -ROOF Proposed Use: Legal Description: Job Address: 615 BROADWAY Contractor's Name CARLOS BUSTAMANTE TOTALS Permit Fee TOTAL FEE................. PAYMENTS..................$0.0 TOTALDUE ................. Type Address M 1544 14TH AVE S #4 Fee $ 50.00 $50. 00 $50. 08 DATE RECEIPT # ag �S7_ PAID OCT 18 1995 License# 601632418001 T SIGNATURE: X I HEREBY CERTIFY 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 BE COMPLIED WITH WHETHER SPECIFIED HER I'N R N BUILDING OFFICIAL CITY OF ARLINGTON CONSTRUCTION PERMIT ❑ COMBINATION ❑ BUILDING MECHANICAL ❑ PLUMBING ❑ SIGN � PERMIT NO. �S-f �-7 OWNER MAIL ADDRESS CITY Z1► PHONE ARCHITECT OR DESIGNER MAIL ADDRESS my 71P ounur GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE TIC NSE MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE tono CgI^Lc� e ,�tirRmw� 544- ig� AU1 Afi I t�i?zz q.911�q ?2Z -0`�3i a,0► k3�azlr PLUMBING CONTRACTOR /ZEMC CCU r l �- MAIL ADDRESS CITY ZIP PHONE LICENSE I C — P, 3 CLASS OF WORK Q Q NLW ❑ ADDITION Cl ALTERATION ❑ REPAIR ❑ DEMOLI I ION ❑ BUILDING RELOCATION Q VALUATION OF WORK ULSC IBL WORK PRUPOSi U USE OF BUILDING I HEREBY CERTIFY THAT I HAVE BEAD AND EXAMINED THIS APPLICA- TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- SIONS SIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOFWORK 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 OF THE PERFORMANCE OF CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE. SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE x PRUPtR1Y(SttOWNBELOW URATIACNFOUR COPIES) LUr BLOCK • Or TAX ID NUMBER FROM PROPERTY TAX STATEMENT 108ADDRESS (OPFICE USB ONLY) PLUMBING MFCIIANICAL NO. TYPE OF FIXTURE FEE :'a FIXTURES NO. TYPE OF EQUIPMENT PER FIXTURES ATER CLOSET TOILED $7.00 UL COND. UNITS — H.P. EA. d . Ilt•• ATHTUB $7.00 tEPRIGERATION UNI'1S — H.P. BA F 'do. ut•• VATORY ASH BASIN $7.00 301LERS — H.P. EA d . Bt•• ROWER. $7.00 JAS FIRED A.C. UNITS — TONNAGBEA. d .Ilt•• TCHEN SINK & DISPOSAL $7.00 FORCED AIR SYSTEMS — B.T.U. MEA $9.00 ISHWASHER $7.00 NALL HEATERS — B.T.U. M S9.00 UNDRY TRAY $7.00 INIT HEATERS — B.T.U. M $9.00 LATHES WASHER $7.00 VAPORATIVBCOOLERS AT13R HEATER $7.00 LATHES DRYERS $6.50 RINAL $7.00 VENTILATION FAN 94S0 KINKING FOUNTAIN $7.00 ZMGE HOOD COMMERCIAL S6.50 LOOR DRAIN $7.00 Bi HANDLING UNIT — CPM VACUUM BREAKERS S7.00 VE $6.50 OOF DRAINS — RAINLEADERS $7.00 ASTAL FIREPLACE R CHIMNEY S6SO INK SERVICE — BAR, ETC. $7.00 WATER HEATER 36.50 AS PIPING *(up to S - $3.00. eddol. S.7S -Equipment list must be provided SUB TOTAL SUB TOTAL PERMIT PERMIT TOTALFEB TOTALFEE SIDL YARU SE I BACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN FEE CHECK FEE RECEIPT NO. USt /UNt LOT ARIA VACANT SITE ❑ YES ❑ NO FEES VALUATION FEE PLAN CHECKING NG TYPE OE CONS1 OCCUPANCY GROUP NO. OF DWELLING UNITS BU'LDING $ SIlL vl BLDG No. Of STORIES MAX. OCC. LOAD PLUMBING FIRE SPRINKLLRSREQUIRED ❑ YES FIND MECHANICAL COMMENTS STATE BLDG. CODE ENERGY CODE SURCHARGE PENALTY U.B.C. SEC. 303(a) WATER/SEWER FEES TOTAL PERMIT VALIDATION WHEN PROPERLY VALIDATED ON THIS SPACE) THIS IS YOUR PERMIT 6 RECEIPT PAID CRk BY cc: ASSESSOR. APPLICANT, TREASURER. BLDG. DEPT. BUILDING OFFICIAL RECORDS COPY DATE C I -rY OP R RL I N0-rOIV COMO-r RLJCT I ON PERM I T PERMIT NO- 0 SM—IaS7 Owner: SAHAGUN, RUBEN 515 BROADAY ARLINGTON 98223 Value of Work: $1,800.00 Tax ID: Phone: 435-9433 Describe Work: RE -ROOF Proposed Use: Legal Description: Job Address: 615 BROADWAY Contractor's Name CARLOS BUSTAMANTE TOTALS Permit Fee TOTAL FEE ................. PAYNENTS..................$9.0 TOTAL DUE ................. Type Address M 1544 14TH AVE S #4 Fee $50.00 $50. 00 $50. 00 DATE RECEIPT # PAID OCT 18 1995 License# 601632418001 SIGNATURE: r��z'zt, -' I HEREBY CERTIFY 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 BE COMPLIED WITH WHETHER SPECIFIED HER IN R N BUILDING OFFICIAL - CITY OF ARLINGTON CONSTRUCTION PERMIT ❑ COMBINATION ❑ BUILDING MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO.� j OWNER MAIL ADDRESS CITY ZIP PHONE NE rv�e�i �ct�;1 (�� "m� LC'Aq ARCHITECT OR DESIGNER MAIL ADDRESS ` CITY ZIP PHONE GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE 0 MLCIIANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE 10610 f�:,_':7-A,/nA!j; i _ 11;44 1`+_"" AU< < AFT I MR CA I � y8l`f� �Z2 -0 j 3,I (01 k3? I001 PLUMBING CONTRACTOR kErl1CrC(j l MAIL ADDRESS J? CITY ZIP PHONE LICENSE 3 CLASS OF WORK CO ❑ NLW 0 ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLI I ION 0 BUILDING RELOCATION QVALUATION OF WORK W UESCg18E WORK �)F in PROPOSI D USE OF BUILDING to I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- w TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- LLGAL UtS( RIPIIUN UT PROPERTY ISIIOWN BELOW OR ATTACH FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK LUI BLOCK • OF WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT. THE a GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITYTO ' U.1 VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR a TAX ID NUMBER FROM PROPERTY TAX STATEMENT LOCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF (L CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE. V 108 AVIJRI.SS SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE t x (OPFfCE IISE ONLY) PLUMBING — MECHANICAL NO. TYPE OF FIXTURE FEE i'a FIXTURES NO. TYPE OF EQUIPMENT FEE z's FIXTURES WATER CLOSET OILEI S7.00 lR COND. UNITS — HP. EA Li . Ilt•• ATHTUB $7.00 RIGERATION UNITS — H.P. EA ul . lit•• AVATORY ASH BASIN $7.00 30ELERS — IIP. EA 3qdp. lit•• HONRER $7.00 3AS FILED A.C. UNITS — TONNAGE EA uT . Ilt•• TCHEN SINK R DISPOSAL $7.00 ORCED AIR SYSTEMS — B.T.U. MEA $9.00 1SHWASHER $7.00 ALL HEATERS — B.T.U. M S9.00 AUNDRY TRAY NIT HEATERS — B.T.U. M $9.00 'LOTHI3S WASHER VAPORATTVECOOLERS WATER HEATER P$7.00 LOTHES DRYERS $650 RINAL VENTILATION FAN $4.50 RINKING FOUNTAIN GE HOOD COMMERCIAL $650 ILOOR DRAIN $7.00 tilk HANDLING UNIT — CPM VACUUM BREAKERS S7.00 MOVE 56S0 OOF DRAINS — RAINLEADERS $7.00 vIETAL FIREPLACE & CHIMNEY S650 'INK SERVICE — BAR, ETC. S7.00 WATER HEATER S6.S0 AS PIPING *(up to S - $3.00. eddnl, m S.7S Equipment list must be provided SUB TOTAL SUB TOTAL PERMIT PERMIT TOTALFEE TOTALPBE SIDE, YARD Ai9ACK STRLLISLTBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN FEE CHECK FEE RECEIPT NO. USF /ONt LOT AREA VACANT SITE ❑ YES ❑ NO FEES VALUATION FEE PLAN CHECKING VG TYPE OF CONS1 (X:CUPANCY GROUP NO. OF DWELLING UNITS BU'LDING S SILL OI BLDG. NO. OF STORILS MAX. OCC. LOAD PLUMBING F IRE SPRINKLERS REQUIRED ❑ YES ❑ NO MECHANICAL COMMENTS 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 PERMIT & RECEIPT PAID CR0 BY cc: ASSESSOR, APPLICANT, TREASURER, BLDG. DEPT BUILDING OFFICIAL DATE RECORDS COPY CITY OF ARLINGTON CONSTRUCTION PERMIT ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO.00927 PHONE OWNER MAIL ADDRESS CITY ZIP Ruben Sahagun 615 Broadway Arlington 98223 ARCHITECT OR DESIGNER MAIL ADDRESS CI Fi' ZIP PHONE PHONE LICENSE # GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP R - *p MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE iY PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N CLASS OF WORK ❑ NLW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION VALUATION OF WORK S URR 7 R1 BE WORK P O t7. Lj yt F .r Residence 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 AUTHORITYTO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE. SIC NATUREOFCONTRACTOR ORAUTHORIZEDAGENT DATE x LEG AL DESCRIPTION OF PROPERTY ISHOWN BELOW OR ATTACH FOUR COPIES) LOT -BLOCK -OF TAX ID NUMBER 615 Broadwa Arlin ton iOB ADDRESS (OFFICE USE ONLY) PLUMBING MECHANICAL NO TYPE OF FIXTURE FEE NO. TYPE OF EQUIPMENT FEE WATER CLOSET (TOILET) AIR COND UNITS - H P EA. BAIHTUB REFRIGERATION UNITS - HP EA LAVATORY (WASH BASIN) BOILERS - H.P. EA SHOWLR GAS 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 UNIT HEATERS- B.T.0 M CLOIIiES WASHER EVAPORATIVE COOLERS W'AT LR HEATER CLOTHES DRYERS URINAL VENTILATICN FAN DRINKING FOUNTAIN RANGE HOOD COMMERCIAL FLOOR DRAIN AIR HANDLING UNIT - CPM VACUUM BREAKERS STOVE ROOF DRAINS - RAINLEADERS METAL FIREPLACE & CHIMNEY SINK (SERVICE - BAR, Lrc,) WATER HEATER GAS PIPING SUBTOTAL S SUBTOTAL $ PERMIT $ PERMIT $ TOTALFEE $ TOTAL FEE ; SIDE YARD SE [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 VG TYPE OF CONST OCCUPANCY GROUP NO. OF DWELLING UNITS BUILDING 195 5 ( SIZE OF BLUE, NO. OF STORIES MAX. OCC. LOAD PLUMBING }' FIRE SPRINKLERS REQUIRED ❑ YES ❑ NO MECHANICAL COMMENTS Remodel only interiors STATE BLDG. CODE ENERGY CODE SURCHARGE 4 5( PENALTY U.B.C. SEC.3o3(a) WATER/SEWER FEES TOTAL 200 0 ( PERMIT VALID ON WHEN PROPER V IDATED (IN THIS SPACE) THIS IS YOUR PERMIT & RECEIPT 8�- -92 26027 PAID CRn_ A BY fl L cc: ASSESSOR, APPLICANT, TREASURER, BLDG DEPT INUILD)NGOFFICIAL 1 RECORDS COPY DATE — CITY OF ARLINGTON CONSTRUCTION PERMIT r ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑' PLUMBING ❑ SIGN PERMIT NO.1i UW ER 641-e See �/1 y MAIL DREG CITY /5 f a (,��r a �GT' 7a,L ZIP 9d �2 - PHONE ARCHITECTOR DESIGNER MAIL ADDRESS CITY ZIP PHONE GENERAL CONTRACTOR /y"MAIL ADDRESS CITY % ✓ ZIP ( f UPHONE I L� SEG MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE IF PLUMBING CONTRACTOR MAIL ADDRESS f` - LICENSE IT CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITI VALUATION OF WORK ; , K DESCRIBE RK na.,wict 1% 1 icc nc ai III n1mr. L-LLAL DES('RFPTION OF PROPERTY M"N BELOW OR ATTACH FOUR LUI BLOCK OF TI SI V\ G THIS P - 1.� CT ALLLPROVIROVI- II -YPE OF WORK OR NOT. THE -2 1/ AUTHORITY TO VI L( % Cl sl( MECHANICAL NO. TYPE OF EQUIPMENT itK JIAIt UK =ORMANCEOF DF ISSUANCE. FEE TAX ID NUMBER JOB ADDRI,SS (OFFICE USE ONLY) PLUMBING NO, TYPE OF FIXTURE FEE WATER CLOSET (TOILLT) COND. UNITS - H.P. EA. A I III UB REF GE RATION UNITS - H.P. EA. LA TORY )WASH BASIN) BOILER H.P. EA SHOWL GAS FIRED . UNITS - TONNAGE EA. KI ICI ILN K & DISP. FORCED AIR SY EMS - B.T.U. MEA DISHWASHER WALL HEATERS- . .U. M LAUNDRY TRAY UNIT HEATERS - B.T. M CU IHLSWASHER EVAPORATIVECOOLERS WAIER HEATER CLOTHES DRYERS URINAL VENTILATION FAN DRINKING FOUNIAIN 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 ; PERMIT f PERMIT f TOTALFEE ; TOTAL FEE f SIDL YARD SE I BACK STRLEI SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN FEE CHECK FEE RECEIPT NO. USE CON) LOT AREA VACANT SITE ❑ YES ❑ NO FEES VALUATION FEE PLAN CHECKING VG TYPE OF CONST OCCUPANCY GROUP NO. OF DWELLING UNITS BUILDING f SIZE OF BLDG. NO. OF STORIES MAX. OCC. LOAD PLUMBING FIRE SPRINKLERS REQUIRED' ❑ YES ❑ NO MECHANICAL COMMENTS � STATE BLDG. CODE ENERGY CODE SURCHARGE PENALTY U.B.C. SEC. 303(a) WATER/SEWER FEES TOTAL V- PERMIT VALIDATION WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS 15 YOUR PERMIT & RECEIPT PAID v _q l CR# ?� �BY - OP 0 cc: ASSESSOR, APPLICANT, TREASURER, BLDG, DEPT BUILDING OFFICIAL RECORDS COPY DATE CITY OF ARLINGTON CONSTRUCTION PERMIT ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO. OW ER MAIL DREG CITY ZIP PHONE ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE A MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE 11 PLUMBING CONTRACTOR MAIL ADDRESS ""' "` LICENSE ,T CLASS OF WORK ❑ NLW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITI VALUATION OF WORK LIESCRIBE W RK C !� PROV USE OF BUILDING I d THIS APPLICA- TI CT ALL PROVI- LL4AL DES(RIPTION OI PROPERTY (SKOWN BELOW OR ATTACH FOUR COPIE5) SI YPE OF WORK LUI BLOCK OF V\ OR NOT. THE G �UTHORITYTO VI I �' iER STATE OR TAX ID NUMBER U L -'ORMANCEOF Cl DF ISSUANCE. fF 108 ADDRLSS sic Z_ �46L� w l-L 4-1Tv: I (OFFICE USE ONLY) MECHANICAL NO TYPE OF FIXTURE FEE NO. TYPE OF EQUIPMENT FEE WATER CLOSET (TOILLT) R COND. UNITS - H.P. EA. A III] UB REF GERATION UNITS - H.P. EA. LA TORY (WASH BASIN) BOILER H.P. EA SHowtv, GAS FIRED Xr, UNITS - TONNAGE EA, KI ICI ILN K & DISP. FORCED AIR S EMS - B.T.U. MEA DISHWASHER WALL HEATERS - . .U. M LAUNDRY TRAY UNIT HEATERS - B.T. M CLOIHLSWASHER EVAPORAIIVECOOLERS WAILRHEATLR CLOTHES DRYERS URINAL VENTILATICN FAN DRINKING FOUN I AIN 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 SUBTOTAL ; SUB TOTAL ; PERMIT ; PERMIT ; TOTAL FEE $1 TOTAL FEE ; SIDL YARD SE IBACK STRLET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN FEE CHECK FEE RECEIPT NO. USE /.DNE LOT AREA VACANT SITE ❑ YES ❑ NO FEES VALUATION FEE PLAN CHECKING NG TYPE OF CONST. OCCUPANCY GROUP NO. OF DWELLING UNITS BUILDING ; t SIZE OF BLDG. NO. OF STORIES MAX. OCC. LOAD PLUMBING FIRE SPRINKLERS REQUIRED ❑ YES ❑ NO COMMENTS % MECHANICAL STATE BLDG. CODE ENERGY CODE SURCHARGE PENALTY U.B.C. SEC. 303(a) WATER/SEWER FEES TOTAL 67 PERMIT VALIDATION WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT & RECrt PAID J� CR# '7 �By_ 7 CC: ASSESSOR, APPLICANT, TREASURER, BLDG. DEPT, I BUILDING OFFICIAL DATE RECORDS COPY CITY OF ARLINGTON CONSTRUCTION PERMIT ❑ COMBINATION ❑ BUILDING ® MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO.00537 OWNER MAIL ADDRESS CITY ZIP PHONE Mike Liberda 615 N. Broadway Arlington, WA 98223 435-0775 ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE M MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE # CLASS OF WORK NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ DEMOLITION []BUILDING RELOCATION VALUATION OF WORK $ 10.0.00 DESCRIBE WORK Install Furnace - Gas Piping PROPOSED USE OF BUILDING Residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- LLGAL DES( RIPTION Of PROPERTY (SHOWN BELOW OR ATTACH fOUIR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK LOT —BLOCK of 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 TAX ID NUMBER LOCAL LAW REGULATING CONSTRUCTION OFTHE PERFORMANCE OF CONSTRUCTION. PERMIT EXPIRES I YEAR FROM DATE OF ISSUANCE. SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE IOB ADDRLSS � 615 Broadway X ,.r ��,e, A/S 0 eo (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.0 UNITS - TONNAGE EA. KI ICHLN SINK & DISP 1 FORCED AIR SYSTEMS — B T.U. MEA DISHWASHER WALL HEATERS — B T.0 M LAUNDRY TRAY I UNIT HEATERS — B T U M CLOT I iES WASHER EVAPORAT I`VE COOLERS WAIERHEATLR CLOTHES DRYERS URINAL VENTILATICN FAN DRINKINC, FOUN LAIN 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 3 0' SUB TOTAL f SUBTOTAL ; 0 PERMIT ; PERMIT $ 15 0 TOTAL FEE ; TOTAL FEE ; 27 0 SIDE YARD SE [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 i SIZE OF BLDG NO. OF STORIES MAX. OCC LOAD PLUMBING FIRE SPRINKLERS REQUIRED ❑ YES ❑ NO MECHANICAL COMMENTS Mechanical Only STATE BLDG. CODE ENERGY CODE SURCHARGE U.PENALTY SE C SEC. 303(a) WATER/SEWER FEES TOTAL 27 00 PERMIT VAL TION WHEN PROP RLLIDATED (IN THIS SPACE) THIS IS YOUR PE MIT & RECEIPT PAID — CR# _ 23115 YOUR ASSESSOR, APPLICANT, TREASURER, BLDG DEPT .v LFiE Wrri— (COPY DATE CITY OF ARLINGTON CONSTRUCTION PERMIT ❑ COMBINATION ❑ BUILDING ❑ MECEIANICAL ❑ PLUMBING ❑ SIGN PERMIT NO. " OWNER ��'eY�� MAIL ADDRESS `6 CITY ', ZIP PHONE 1S t � lr''i 7�S�o� ARCIIiIE.CTOR DESIGNER MAIL ADDRESS CITY ZIP PHONE GENERAL CO (.FOR MAIL ADDRESS CHY ZIP PHONE LIC NSE I ML(IIANI CON RACIOR MAIL ADDRESS CITY 71P PHONE LICENSE PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PIIONE LICENSE! CLASS OF WORK ®NIW ❑ADDITION ERATION ®REPAIR ❑DF.MOLJIION ❑BUILDIN(,OfLOCATION VALUAI ION Of WORK �r I /r DESCRIBE WORK sR0P0; USE 01 BUILDING. 7 f FBI IEREBY CERTIFY THAT I I IAVE READ AND EXAMINED THIS APPLICA- ` TION AND KNOW IHF SAME TO BE TRUE AND CORRECT ALL PROVI- .LE..aI 01 V RiPlICTNOI PROPI R1 Y ISIIF)WN R1 1 OW OR Al IA( It FOUR (01`11 GI SIGNS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK _OI BLOCk OI _ _ WILL OF COMPLIED WITH WI IETI TER 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 TAX ID NUMBER 1 OCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE. Si(iNATL -RE OF CONTRACTOR URA( lit 10 2ED AGENT DATE )B ADDRI St (OFFICE USE ONLY) A11-CIIANICAL PLUMBING (1 TYPE OF I IXTURE I EL NO TYPE OF EQUIPMENT FEE WAILRCLOSLI (IOILLI) AIRL,OND UNITS IIP EA 8, IIIUB RLFRIGLRAIIONUNIIS- IIP,LA LAVA R (WASHBASIN) ROIL[ IRS If P EA S110) %LR (,AS FIRED A C UNITS - TONNAGE EA KI ICIILN SINK )ISP 1 ORCED AIR SYSIEMS_- B T U MEA Q DISIIWASIILR - WALI IILAIERS - B F U M III AIERS B 1 U M LAUNDRY FRAY CLOIIILS WASIII R _UNIT LVAPORAIIVE COOLLRS tt,\ILR IILAILR CLOIIILSOPYERS URINAL VLNIILA IICN FAN DRINKIN(, I OLIN I AIN RANGL IIOOD COMMERCIAL I LOUR DRAIN AIR IIANOLING UNI F - CPM VACUUMBRLAKERS STOVE ROOF DRAINS RAINLLADLRS MLIAL FIREPLACE &CHIMNEY SINK ISLRVICL - BAR. L IC) HEATER _WATER GAS PIPING SUB TOTAL I SUBTOTAL I PERMIT I PERMIT I IOTALFEE I' TOTALFEE f SIDI S>RD SL IBACK SIRU I 51 IBACK RE AR YARD SE T BACK VACANT SITE ❑ YES ❑ NO NO Of DWELLING UNITS MAX OCC LOAD IIRE S NKLERSREQUIRED ❑ YES NO PLAN CIIECK NUMBS R FEES PLAN CHECKING `TG BUILDING PLUMBING MECHANICAL PLAN FEE CIIECK FEE RECEIPT NO. U54 /()NJ ( AR4 A VALUATION FEE IYPL OF CONS OCCUPANCY G. (IP I SIZE 01 BI-O(, NO 01 STORIES COMMENTS 44A STATE BLDG. CODE ENERGY CODE SURCHARGEPENALTY WATER/SEWER FEES TOTAL U.BC. SEC. 303(a) DEC 0 1990 CITY OF ARLiATON cc ASSESSOR. APPLICANT. TREASURER. SLOG DEPT PERMIT VALIDATION WHEN PROPERLY VALIDATED TIN THIS SPACE) THIS IS YOUR PERMIT & RECEIPT PAID CRs BY BUI( DING OFFICIAL RECORDS COPY DATE