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HomeMy WebLinkAbout17708 79TH DR NE_BLD1283_2026 c.�"y RESIDENTIAL PLUMBING r.. 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 PLUMBING INSTALLATION FOR EXISTING RESIDENCES. PLEASE FILL OUT ALL PAGES OF THIS APPLICATION AND INCLUDE ALL INFORMATION. Project Address: / 72Z -2 TtT-4 .V Q.. /V t— Project Description: " r6 t�5k� W� L'o Owner: (, 0 Address: City: State: Zip Code: Phone: Email: Applicant: lj94— IoL) "71 f'WH 0M Address: � �j p C{ Comet ri City:_ te: 01-zip Code:?,oy 2Zl Phone:��a^ 20—,P) 1 -3 Email: CONTRACTOR INFORMATION Contractor Name: Address: City: State: Zip Code: License Number:Tf�Zi(7 Expiration: Phone: ci�7 Email: STAFF USE ON \ Received Permit#: —�� 3?j Accepted by: Date JAN 2017 REV 2015 Page 7 of 2 CITY OF ARLINGTON r � 0 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:17708 79th Drive NE Permit#:1283 Parcel#: Valuation:0.00 OWNER APPLICANT CONTRACTOR Name: Name:Tri-County Plumbing Name:Tri-County Plumbing Address: Address:1004 Commercial Ave Address: 1004 Commercial Ave City,State Zip:, City,State Zip:Anacortes,WA 98221 City,State Zip:Anacortes,WA 98221 Phone: Phone: Phone:360420-5753 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name:Tri-County Plumbing Address: Address: 1004 Commercial Ave City,State,Zip: City,State,Zip:Anacortes,WA 98221 Phone: Phone:360-420-5753 LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Residential Plumbing 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. IBCI IO/IRC110. SALES TAX E:Sales taotingloc struction and construction materials in the City of Arlington m be o sales tax return form and coded o rlington#310 I Signature 'rMt Nt5-me Date _/ cl ed Date CONDITIONS Approved as submitted. 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 1/11/2017 Plumbing Permit Base Fee $25.00 1/11/2017 Processing/Technology Fee $0.00 1/11/2017 Water Heater $25.00 Total Due: $50.00 Total Payment: $0.00 Balance Due: $50.00 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 CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:17708 79th Drive NE Permit#:1283 Parcel#: Valuation:0.00 OWNER APPLICANT CONTRACTOR Name: Name:Tri-County Plumbing Name:Tri-County Plumbing Address: Address:1004 Commercial Ave Address: 1004 Commercial Ave City,State Zip:, City,State Zip:Anacortes,WA 98221 City,State Zip:Anacortes,WA 98221 Phone: Phone: Phone:360-420-5753 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name:Tri-County Plumbing Address: Address: 1004 Commercial Ave City,State,Zip: City,State,Zip:Anacortes,WA 98221 Phone: Phone:360-420-5753 LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Residential Plumbing 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/IRCI10. SALES TAX .E:Sales taoingtoc slruclion and construction materials in the City of Arlington m be d o sales tax return form and coded y o rlington#310 I Signature Iff7 RIC Date el ed Date CONDITIONS Approved as submitted. 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 1/11/2017 Plumbing Permit Base Fee $25.00 1/11/2017 ProcessingfTechnology Fee $0.00 1/11/2017 Water Heater $25.00 Total Due: $50.00 Total Payment: $0.00 Balance Due: $50.00 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. ,`- � , �, � 1/11/2017 TRI-COUNTY PLUMBING f { Moir,.. .spa,i'I Search L&I� A-Z,Ind(,: .3afety Health Claims& Insurance Vlorkplace Rights Trades Licensing Washington State Department of Labor & Industries TRI-COUNTY PLUMBING Owner or tradesperson 1004 COMMERCIAL ST PMB 1101 PERKINS, RICHARD KEITH ANACORTES,WA 98221 360-755-3074 Principals SKAGIT County PERKINS, RICHARD KEITH,OWNER WA UBI No. Business type 602 787 165 Individual License Verify the contractor's active registration/license/certification(depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties PLUMBING License no. TRICOP"910K1 Effective—expiration 05/21/2009—05/21/2017 Bond CBIC $6,000.00 Bond account no. SI2213 Received by L&I Effective date 05/21/2009 03/05/2009 Expiration date Until Canceled Insurance Contractors Bonding&Insuranc $1,000,000.00 Policy no. C11 SI2213 Received by L&I Effective date 01/11/2017 03/05/2015 Expiration date 03/05/2018 Insurance history Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period,but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. 1101p us improve https://secure.ini.wa.gov/verify/Detaii.aspx?UBI=602787165&LIC=TRICOP"910K1&SAW= 10 1/11/2017 TRI-COUNTY PLUMBING Workers' comp No active workers'comp accounts during the previous 6 year period. Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. ©Washington State Dept,of Labor&Industries.Use of this site is subject to the laws of the state of Washington. Help us improve https://secure.ini.wa.gov/verify/Detail.aspx?UBI=602787165&LIC=TRICOP"910K1&SAW= 212 al� o, RESIDENTIAL PLUMBING 41 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 PLUMBING INSTALLATION FOR EXISTING RESIDENCES. PLEASE FILL OUT ALL PAGES OF THIS APPLICATION AND INCLUDE ALL INFORMATION. Project Address: _ Ste_ - Project Description: fit—.1y � �6 to Owner: N(, 0 Address: City: State: Zip Code: Phone: Email: Applicant: -' rJ / "wm a(a 4" Address: � D p q 6sm N( City: te: �ip Code:�� 2 1� ---- - Phone: r/ia^ *2o-- 7J ,3 Email: CONTRACTOR INFORMATION Contractor Name: Ste` 4,E Address: City State: Zip Code: License Number:`DIA e. o ? 7V= 1 Expiration:��� Phone:_, f'1'%Z� Email-.- STAFF USE ON Received Permit#: ? Accepted by: Date BAN 11 2017 REV 2015 Page 7 of 2 RESIDENTIAL PLUMBING PERMIT APPLICATION IN Department of Community& Economic Development City of Arlington • 18204 59th Ave NE •Arlington, WA 98223 • Phone(360)403-3551 Plumbing Section (check all that apply) (Check all that apply and indicate the number of fixtures proposed) U! Bath/Shower Combo (4.0) ` x- U Sink(1.5) x f Shower(2.0) x i Lavatory(1.0) x L Clothes Washer(4.0) x ❑ Water Closet(2.5) x ❑ Dishwasher(1.5) xr Water Heater x ❑; Hose Bibb (2.5) x Water Heater Model# ❑ Other(list) x Proposed Water Piping Size: Proposed Piping Material: Proposed DWV Material: Proposed DWV Size: • All hose bibs required to be equipped with Atmospheric Vacuum Breakers per ASSE 1019 • All water supplies at 80psi or greater shall have Pressure Reducing Valves (PRV) • Cross-Connection-Control may be required Applicant Signature- Date: 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 Artington and the State of Washinglohs REV 2015 Page 2 of 2 Permit#: 1283 Permit Date: 01/1l/17 Permit Type: RESIDENTIAL PLUMBING Project Nam e Nelson Applicant Nam a Tri-County Plum hng Applicant Address: 1004 Com m ccial Ave Applicant, City, State, Zip: Anacortes,WA98221 Contact: Rick Perkins Phone: 360-420-5753 Email: Scope of Work: Replace Gas Water Heater Valuation: 0.00 Square Feet: 0 Num ber of Stories: 0 Construction Type: O xupancy G ioup: ID Code: Permit Issued: 0l/11/2017 Permit Expires: Form Permit Type: Status: LASERFICHE Assigned To: Kristin Foster Property Parcel# Address L egal Description O wner Nam e Cvner Phone Zoning Contractors Contractor P rim ay Contact P hone A ddress C ontractor Type L icense License# Tri-County Plum ling Corn m ecial CONSTRUCTION Labor andng R ichard Perkins 3 60-420-5753 TRICOP*910k1 Ave CONTRACTOR Industries Fees Fee D escription N otes A m amt Plum ling Base P erm i Fee $ 25.00 Processing/Technology $0.00 Water Heater(Tank) $25.00 Total $ 50.00 Attached Letters Date L etter D escription O1/11/2017 Building Perm i Paym sits Date Paid By D escription P aym art Type A ccepted By A m cunt O1/11/2017 Richard Perkins 6 3058979 c c $50.00 O astanding Balance $0.00 Uploaded Files Date File Nam e O1/11/2017 2046237-1283 Issued Permt.pdf O1/11/2017 2046238-1283 Application.pdf