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Home My WebLink About4730 197TH PL NE_BLD1218_2026 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. TM Project Address:4730 Nmot , Arlington WA 98028 Project Description:New Central Heating Owner: Steven Hall Address: 6121 NE 175th St City: Kenmore StateYVA Zip Code: 98028 Phone: 360-961-3638 Email:shl0492@comcast.net Applicant: Steve Hall 6121 NE 175th St -A � J Wq 98028 Address: City: State: Zip Code: Phone: 360-961-3638 Email: sh10492@comcast.net CONTRACTOR INFORMATION Contractor Name:T'$' Address:ZlElf�— City: ARlington State.WA Zip Code: 98223 License Number:XXXXXXX X Expiration: xx/xx/xx Phone:xxx-xxx-xxxx Email:tbd Received STAFF USE ON NOV 1. 8 2016 Permit #: 2�8 Accepted by: Date: 6/16LP Page 1 of 2 AN RESIDENTIAL MECHANICAL f PERMIT APPLICATION 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 #TZHLL-26171A AFUE Heat Pump Model # AFUE HSPE ❑ AC Unit Model # SEER Freestanding Stove Fire Place Insert FJ Outdoor BBQ Q! Gas Piping Solid-Fuel Appliance 1�t Other Gas Piping Information Not Applicable: Pipe Material: Pipe Size: Distance from Meter to Furthest Appliance: Total BTU's of all Appliances: • New gas piping requires a pressure test hooking to any appliance • Sediment traps (drips) are required on all gas lines • 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 •••�• ••••• 11/18/2016 Applicant Signature: Date: Applicant Printed Name: Steven F Hall 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 % CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:4730 197th Street NE Permit#:1218 Parcel#:00671900001900 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:STEVEN HALL Name:Steven Hall Name: Address:6121 NE 175TH ST B402 Address:6121 NE 175th Street Address: City,State Zip:KENMORE,WA 98028 City,State Zip:Kenmore,WA 98028 City,State Zip:, Phone: Phone:360-961-3638 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: Residential Mechanical CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: 1 OCC GROUP: 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 OCCUPANCY HAS BEEN GRANTED. IBC 1 l0/IRC I10. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City ofArlingto iu b rte o your sales tax return form and coded City of Arlington#3101. tor� Steven Hall 11/21/16 (,7 l Signature Print Name Date Released By Date CONDITIONS Duct Testing is required per the 2015 Washington State Energy Code R402.4.1.2 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 11/21/2016 Furnace $25.00 11/21/2016 Mechanical Permit Base Fee $25.00 Total Due: $50.00 Total Payment: $50.00 Balance Due: $0.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the fallowing information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon BUILDING INSPECTION REPORT — MECHANICAL (RESIDENTIAL) Permit No. 1218 Address: 4730 197th Street NE Contractor: Steven Hall Owner: Steven Hall Date: 8/31/2016 ❑ APPROVAL ® PARTIAL APPROVAL ❑ CORRECTION ❑ OTHER APPLIANCE: Furnace CO DETECTOR: ® HEAT PUMP/AC UNIT: ❑ GAS PIPING: ❑ DISCONNECT: ❑ DRIP LEG: ❑ SEISMIC: ❑ VENTING: ❑ 3" PAD: ❑ ACCESS: ® INSULATION/PROTECTION: ❑ SHUT-OFF VALVE: ❑ DUCTS: N/A L&I: Yes Date: 8/31/2016 Inspector: Kevin Olander CITY OF ARLINGTON 238 N. OLYMPIC AVE-ARLINGTON, WA. 98223 PHONE; (360)403-3551 _ BUILDING PERMIT Address:4730 197th Street NE Permit#:1218 Parcel#:00671900001900 Valuation:0 00 OWNER APPLICANT CONTRACTOR Name:STEVEN HALL Name:Steven Hall Name: Address:6121 NE 175TH ST B402 Address:6121 NE 175th Street Address: City,Stale Zip:KENMORE,WA 98028 City,State Zip:Kenmore,WA 98028 City,State Zip:, Phone: Phone:360-961-3638 Phone: MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City,State,Zip: City,State,Zip: Phone: Phone: LIC#: EXP: L1C#: EXP: JOB DESCRIPTION PERMIT TYPE: Residential Mechanical CODE YEAR: 2015 STORIES: CONST.TYPE; DWELLING UNITS: 1 OCC GROUP: BUILDINGS: OCC LOAD: PERMIT APPROVAL 1 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 PERNu'r 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. 1BCI 10/IRCI10. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City ofArlingto u b tte o t your sales tax return form and coded City of Arlington 43101, Steven Hall 11/21/16 Signature Print Name Date Released By Date CONDITIONS I Duct Testing is required per the 2015 Washington State Energy Code R402.4.1.2 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 11/21/2016 Furnace $25,00 11/21/2016 Mechanical Permit Base Fee $25.00 Total Due; $50.00 Total Payment: $50.00 Balance Due: $0.00 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 i - CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:4730 197th Street NE Permit#: 1218 Parcel#:00671900001900 Valuation:0.00 OWNER APPLICANT CONTRACTOR Name:STEVEN HALL Name:Steven Hall Name: Address:6121 NE 175TH ST B402 Address:6121 NE 175th Street Address: City,State Zip:KENMORE,WA 98028 City,State Zip:Kenmore,WA 98028 City,State Zip:, Phone: Phone:360-961-3638 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: Residential Mechanical CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: 1 OCC GROUP: 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 OCCUPANCY HAS BEEN GRANTED. IBC110/IRC110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the City of Arlingtoi m h • rte l o i your sales tax return form and coded City of Arlington#3101. Signature Print Name Date Released By Date CONDITIONS- Duct Testing is required per the 2015 Washington State Energy Code R402.4.1.2 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 11/21/2016 Furnace $25.00 11/21/2016 Mechanical Permit Base Fee $25.00 Total Due: S50.00 Total Payment: $50.00 Balance Due: $0.00 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 ., 1 1 :� s , I Permit Information Date 11/18/2016 Permit Number 1218 Project Name Hall Applicant Name Steven Hall Applicant Address 6121 NE 175th Street City,State,Zip Kenmore,WA 98028 Contact Steven Hall Phone 360-961-3638 Email shl0492@comcast.net Permit Type Residential Mechanical Site Address 4730 197th Street NE Valuation 0.00 Status Applied Permit Issued Permit Expires Square Feet 0 Type of Construction/Occupancy Load Number of Stories 0 Proposed Use Furnace Installation Assigned To Kristin Foster Property Information Owner Information Parcel#:00671900001900 STEVEN HALL STEVEN HALL 6121 NE 175TH ST B402 4730 197TH PL NE KENMORE,WA 98028 Fees Fee Description Notes Amount Furnacel 322.10.00.001 $25.00 Mechanical Permit Base Feel 322.10.00.00 $25.00 Total $50.0 Uploaded Files Upload File Date File Uploaded By I 4 �. 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:4730 ` t , Arlington WA 98028 Project Description:New Central Heating Owner: Steven Hall Address: 6121 NE 175th St City: Kenmore StateY/A Zip Code: 98028 Phone: 360-961-3638 Email:shl0492@comcast.net Applicant: Steve Hall 6121 NE 175th St �q h'tof�l� Address: City: State WA Zip Code: 98028 Phone: 360-961-3638 Email: sh10492@comcast.net CONTRACTOR INFORMATION Contractor Name:' Address:'' City: ARlington State WA Zip Code: 98223 License Number:XXXOUWXX Expiration: xx/xx/xx Phone:xxx-xxx-xxxx Email:tbd Received STAFF USE ON NOV 1. 8 2.016 Permit #: ,Zl8 Accepted by: Date: 6/16LP Page 1 of 2 RESIDENTIAL MECHANICAL PERMIT APPLICATION J 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 #TZHLL-26171A AFUE FJ Heat Pump Model # AFUE HSPE ❑ AC Unit Model # SFFR ❑ Freestanding Stove ❑ Fire Place Insert ❑ Outdoor BBQ ❑ Gas Piping ❑ Solid-Fuel Appliance Other Gas Piping Information Not Applicable: 4 Pipe Material: Pipe Size: Distance from Meter to Furthest Appliance: Total BTU's of all Appliances • New gas piping requires a pressure test hooking to any appliance • Sediment traps (drips) are required on all gas lines • 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 �/CwaCG Applicant Signature: Date,• 1v1si2o16 Applicant Printed Name: Steven F Hall 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 BUILDING INSPECTION REPORT — MECHANICAL (RESIDENTIAL) Permit No. 1218 Address: 4730 197th Street NE Contractor: Steven Hall Owner: Steven Hall Date: 8/31/2016 ® APPROVAL ❑ PARTIAL APPROVAL ❑ CORRECTION ❑ OTHER APPLIANCE: Furnace CO DETECTOR: ® HEAT PUMP/AC UNIT: ❑ GAS PIPING: ❑ DISCONNECT: ❑ DRIP LEG: ❑ SEISMIC: ❑ VENTING: ❑ 3" PAD: ❑ ACCESS: ® INSULATION/PROTECTION: ❑ SHUT-OFF VALVE: ❑ DUCTS: N/A L&I: Yes Date: 8/31/2016 Inspector: Kevin Olander Permit#: 1218 Permit Date: 11/18/16 Permit Type: RESIDENTIAL MECHANICAL Project Nam a Hall Applicant Nam a Steven Hall Applicant Address: 6121 NE 175th Street Applicant, City, State, Zip: Kenm ae, WA98028 Contact: Steven Hall Phone: 360-961-3638 Em al: sh10492@corn cast.net Scope of Work: Furnace Installation Valuation: 0.00 Square Feet: 0 Num ber of Stories: 0 Construction Type: O xupancy G ioup: ID Code: Permit Issued: 11/21/2016 Permit Expires: Form Permit Type: Status: LASERFICHE Assigned To: Kristin Foster Property Parcel# Address L egal Description O wner Nam e Caner Phone Zoning 00671900001900 4 730 197TH PL NE S TEVEN HALL 111 Single Fam iy Residence-Detached Inspections Date Inspection Type D escription S cheduled Date C om lieted Date I nspector Status 12/01/2016 R00.FURNACE L&Iperm i required 1 1/30/2016 B UILDING Approved FINAL Fees Fee D escription N otes A m mnt Forced Air Heat f ee per Btu $ 25.00 Mechanical Base P erm i Fee $ 25.00 Total $ 50.00 Attached Letters Date L etter D escription 11/21/2016 Building Perm i Paym sits Date Paid By D escription P aym art Type A ccepted By A m cunt 11/18/2016 Steve Hall 6 2351411 c c $50.00 O astanding Balance $0.00 Notes Date Note C reated By: 11/21/2016 Em tiled perm i for signature.KF K ristin Foster Uploaded Files Date File Nam e O1/03/2017 2031950-4730 197th Street NE.docx 12/01/2016 1973812-4730 197th Street NE.docx 11/21/2016 1961412-1218 Issued Perm i.pdf 11/18/2016 1958965-1218 Apnlication.pdf