HomeMy WebLinkAbout8909 170th Street NE_BLD1516_2026 Y RESIDENTIAL PERMIT APPLICATION
� Z
Department of Community& Economic Development
�PltYG`O City of Arlington • 18204 59th Ave NE•Arlington, WA 98223 • Phone(360)403-3551
THIS APPLICATION IS TO BE USED WHEN APPLYING FOR A NEW SINGLE-FAMILY, DUPLEX, TOWNHOUSE,
ADDITION,DECK,OR ACCESSORY STRUCTURES. THIS APPLICATION MUST BE ACCOMPANIED BY TWO(2)SETS
OF CONSTRUCTION DRAWINGS AND TWO(2)SETS OF STRUCTURAL CALCULATIONS. THE APPLICATION MUST
ALSO INCLUDE THE PLUMBING SUBMITTAL AND THE MECHANICAL SUBMITTAL FORMS. THE ZONING
VERIFICATION MAY BE SUBMITTED PRIOR.
Project Address: ��(,� / � ,' '5 � r� Plat: 0Aaz 5%
U Single-family ❑ Duplex ❑ Townhouse Addition ❑ /ccessory structure
Proposed Area: 15' Floor: r - 2"d Floor: Garage: Total SF: /L
Describe Proposal (include cross street):
4 e2 1?0 trt!>'� ;e'
Valuation:
Owner: L�,, i- y'�, - 1.14,SJ-k nJC,7t-,�_
Address: 11 12D A l�Y-14.. l-4/03 City: State: Zip Code: 7�
Phone: Email: id' D�Y1lS moo_A/�.�y��S ao*
Applicant: "1 I-Wq0 ' 4SA"7b J C b�-
Address: llglp Alf- City: LAX State:l Zip Code:
Phone: �' �� Email: YttATrAA'k 5
Contractor: / !� S I�@—
Address: AJV_ City: t� State: Zip Code:
Phone: Email: {2i'12i'm a(a_L�►(wat-�
Contact Person: License Number:L14W4857W Expiration:
6/16LP Page 1 of 3
'` RESIDENTIAL PERMIT APPLICATION
9 0 Department of Community& Economic Development
City of Arlington • 18204 59th Ave NE•Arlington, WA 98223• Phone(360)403-3551
Plumbing Section (continue filling out if plumbing is involved)
(Check all that apply and indicate the number of fixtures proposed)
61 ` Bath/Shower Combo (4.0) x I [ - Sink(1.5) x
l
�j Shower(2.0) x � 111-1-avatory(1.0) x
�l Clothes Washer(4.0) x [�t—GVater Closet(2.5) x
f4 -Dishwasher(1.5) x �a--Water Heater x
W— Hose Bibb (2.5) x Water Heater Model#
(Other(list) x I (� -� 0A
Plumbing Section Continued
Proposed Water Piping Size: 3j& Proposed DWV Material: � S
1(
Proposed Piping 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)
6/16LP Page 2 of 3
RESIDENTIAL PERMIT APPLICATION
• Department of Community&Economic Development
t 1 City of Arlington • 18204 59th Ave NE•Arlington,WA 98223 • Phone(360)403-3551
Mechanical Section (continue filling out if mechanical equipment is involved)
Select proposed appliances:
ll
Furnace(80+) Model# AFUE F�
❑ Heat Pump Model# SEER HSPE
❑ AC Unit Model# SEER
❑ Type II Hood ED Commercial Cooking Appliance ❑ Hydronic Piping
❑ Boiler Q1 Solid-Fuel Appliance UJ PV System
❑ Fireplace Insert ❑ Outdoor BBQ ❑ Storage Tank
Freestanding Stove Gas Piping ❑ Other
Gas Piping Information
Not Applicable::Z j
Pipe Material: (Pipe Size: I( Total BTU's of all Appliances:
Distance from Meter to Furthest Appliance: 7
• New gas piping requires a pressure test to 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 is required within 6 feet of all appliances
Applicant Signature: Date: I
Print Applicants Name: �li1A�►"� Q-t�� S l
6/16LP Page 3 of 3
CITY OF ARLINGTON
238 N. OLYMPIC AVE -ARLINGTON, WA. 98223
PHONE; (360)403-3551
BUILDING PERMIT
Address:8909 170th Street NE Permit#• 1516
Parcel#:01166900005600 Valuation: 187421 13
OWNER APPLICANT CONTRACTOR
Name:LGI HOMES-WASHINGTON LLC Name:LGI Homes-Washington,LLC Name:LGI Homes-Washington,LLC
Address: 1450 LAKE ROBBINS DR STE 430 Address:11410 NE 124th Street,Ste#103 Address: 11410 NE 124th Street,Ste#103
City,State Zip:THE WOODLANDS,TX 77380 City,State Zip:Kirkland,WA 98033 City,State Zip:Kirkland,WA 98034
Phone: Phone:425-785-0797 Phone:360-353-0588
MECHANICAL CONTRACTOR PLUMBING CONTRACTOR
Name: Name:
Address: Address:
City,State,Zip: City,State,Zip:
Phone: Phone:
LIC#: EXP: LIC#: EXP:
JOB DESCRIPTION
PERMIT TYPE: Single Family Residence CODE YEAR: 2015
STORIES: I CONST.TYPE: `I-$
DWELLING UNITS: 1 OCC GROUP: R-3
BUILDINGS: OCC LOAD:
PERMIT APPROVAL R i
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 110/IRC 110.
SALES T NO 1 .E:Sales tax relating to construction and construction materials in the City of Arlington must be reported on your sales tax return form
and c&Ilyzff�U'9101101
/
Signat a Print Name Date Re eased By Date
CONDITIONS
Adhere to approved plans.
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
6/20/2017 Building Permit Fee $2,109.12
6/20/2017 Building Plan Review Fee $1,370.93
6/20/2017 Furnace $25.00
6/20/2017 Gas Outlets Base Fee 1 to 5 $10.00
6/20/2017 Mechanical Fee(Enter Fixture Fee) $25.00
6/20/2017 Mechanical Permit Base Fee $25.00
6/20/2017 Park-Community SF $1,662.00
6/20/2017 Plumbing Permit Base Fee $25.00
6/20/2017 Plumbing Permit Fee(Enter Fixture Fee) $132.00
6/20/2017 Processing/Technology Fee $25.00
6/20/2017 State Building Code Surcharge Fee $4.50
6/20/2017 Traffic Mitigation $3,355.00
6/20/2017 Water Heater $25.00
Total Due: $8,793.55
Total Payment: $8,793.55
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
SETBACKS NOTES.•
FRavr SO' •BUILDING D1MDV. aVS ARE 70
SIDE I I ` REAR 5' � 9 MNAAS�pV
ACTUAL L00'A110W MAY VARY
••SLOPE DRIVEWAY IV PUBLIC ROAD
I •2T fDVX 70 BE INSTALLED PLR
RNIRM CONTOUR I I PROPERTY arr Of'ARLING7A1/S STANDARD
(lyp) I ( COgNB? •S/LT fDg TO LF INSTALLM OW
J — 5'BSBL— — (T)P.J we T 9DE OIL BUILDING
PARCa
450— N897049"W ' — — — — — — — ,C1907RUcncw BKRANX 70 BE
INSTALLE7 PLR aTY AF"
— — —4� — 45.00 �� ARLING7t9W S STANDARDS
r — T- --- - - � — — — — — STORMNOTES.•
I _ I g r — — -ZSWCsnP rALLEDv PRIOR fit
I
5'8-W
i I •BARE S6WS COVDPLO MIA'/MULCH
I 24.50 5 I .W aL PER NR �7513
"
PAAO 12 SFI I g i �WSJ N
, OW CXNECU TO
5'LSL PR/WE S7W M SNUB
f0.50 EXISANG G10WfiX/R
•97E SHALL BE STABILIZED PRIOR
I
LOT 56 I (7�) R AUM G PENIA/T 6tElNG
=W PROPOSED RESYYDEIVa I SITE NOTES.•
I p LIACUMB/A-la7 WAX LffT °� •1!A`17L1NE f27OANG DYPA/NS AND
p p ^ I ROAD DVPA/NS 7o PBwANENT
g 2,f09fSJ� $ I STORM DRNNAGE SMW AW
APPROVID PLAT LA4A/mr PLAN
p po I OW RLE MIA'/ PE CWNr
= GARAX I •AREA OIL DISAIRBAN,c'INCUI&N
BUILDING I'ROOF OVERHANG [WARE LOT.
OU&INE I LEGEND.•
4 25 4..00 I o- [SOW OfF
® WA0?MEM?
- - - - - J 5, 11.COg — 19.75 5' ; L _ - - - - - - 4( RREHwRANT
.416 &-. S'PR/VA7E NR VAC
10'PUBLIC DRIVEWAY °
UALIIY EASEMENT 1 g 4 22' g FAST O ® CAT f BASIN
20'BSBL ° $ O aEANGY/T
1. v O
� 45.00 A MANHOLE
APEF Fdl/OVAL
1 ' 4 ° 4° 4
LWAA� \-SWM'aEANa n mw
12'WA1DP� Nowcrgwm CGWNECTION
1 F007/1VG DRAINS
2*0 _ SCALE 1'-20'
LOT 56
170TH ST. NE SITE PLAN
GREGOR Y RA RK
L G/ HOMES PLAN NO. COL.—1487
LOT AREA = 4„I20 SF DATE 511212017 PARCEL # LOT 56
HOUSE= 2,109•SF 14711 NE 2%Place•#101
B.11.—,W..Wg"98-7
DRIVEWAY= 416 SF DESIGNED CORE ADDRESS 1I909 1701H Sr
Flw�
425.885.7877 Fax 425.885.7963
WALKWAY/17A770 = 12 SF oes,cN PROJECT NUMBER
TOTAL= 2,537 SF
ENGINEERING PLANNING • SURVEYING DRAWN CAF 130241-GRGOO
CITY OF ARLINGTON
238 N. OLYMPIC AVE -ARLINGTON, WA. 98223
PHONE; (360) 403-3551
_ BUILDING PERMIT
Address:8909 170th Street NE Permit#:1516
Parcel#:01166900005600 Valuation: 187421 13
OWNER APPLICANT CONTRACTOR
Name:LGI HOMES-WASHINGTON LLC Name:LGI Homes-Washington,LLC Name:LGI Homes-Washington,LLC
Address: 1450 LAKE ROBBINS DR STE 430 Address:11410 NE 124th Street,Ste#103 Address: 11410 NE 124th Street,Ste#103
City,State Zip:THE WOODLANDS,TX 77380 City,State Zip:Kirkland,WA 98033 City,State Zip:Kirkland,WA 98034
Phone: Phone:425-785-0797 Phone:360-353-0588
MECHANICAL CONTRACTOR PLUMBING CONTRACTOR
Name: Name:
Address: Address:
City,State,Zip: City,State,Zip:
Phone: Phone:
LIC#: EXP: LIC#: EXP:
JOB DESCRIPTION
PERMIT TYPE: Single Family Residence CODE YEAR: 2015
STORIES: 1 CONST.TYPE: `I_B
DWELLING UNITS: 1 OCC GROUP: R-3
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 110/IRC 110.
SALES T NO '1 E•Sales tax relating to construction and construction materials in the City of Arlin ton must be reported on your sales tax return form
and code ty f to 3101.
Sigrunt a Print Name Date Re cased By Date
CONDITIONS
Adhere to approved plans.
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
6/20/2017 Building Permit Fee $2,109.12
6/20/2017 Building Plan Review Fee $1,370.93
6/20/2017 Furnace $25.00
6/20/2017 Gas Outlets Base Fee 1 to 5 $10 00
6/20/2017 Mechanical Fee(Enter Fixture Fee) $25.00
6/20/2017 Mechanical Permit Base Fee $25.00
6/20/2017 Park-Community SF $1,662.00
6/20/2017 Plumbing Permit Base Fee $25.00
6/20/2017 Plumbing Permit Fee(Enter Fixture Fee) $132.00
6/20/2017 Processing/Technology Fee $25.00
6/20/2017 State Building Code Surcharge Fee $4.50
6/20/2017 Traffic Mitigation $3,355.00
6/20/2017 Water Heater $25.00
Total Due: $8,793.55
Total P:cvuccnt: SR.79,.55
Balance Doc: 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
Permit Information
Date 6/15/2017
Permit Number 1516
Project Name Gregory Park
Applicant Name LGI Homes-Washington, LLC
Applicant Address 11410 NE 124th Street,Ste#103
City,State,Zip Kirkland,WA 98033
Contact Matt Adams
Phone 425-785-0797
Email matt.adams@lgihomes.com
Permit Type Single Family Residence
Site Address 8909 170th Street NE
Valuation 187421.13
Status Applied
Permit Issued
Permit Expires
Square Feet 1889
Type of Construction/Occupancy Load V-B
Number of Stories 1
Proposed Use New SFR
Assigned To Kristin Foster
Property Information Owner Information
Parcel#:01166900005600 LGI HOMES-WASHINGTON LLC
LGI HOMES-WASHINGTON LLC 1450 LAKE ROBBINS DR STE 430
8909 170th Street NE THE WOODLANDS,TX 77380
Contractors
Contractor Name Primary Phone Email Contractor License License#
Contact Type
LGI Homes-Washington,lake Jabusch 360-353- ake.jabusch@lgihomes.co CONTRACTOR Labor and I-GIHOHL857M
LLC 0588 Industries
Review
Date Type Description I Target Date Completed Date I Assigned To Status
3/15/2017 lResidential Dwellin 3/22/2017 my Rusko In Review
5/15/2017 lResidential Dwellin 3/22/2017 11Rick Karns In Review
Fees
Fee Description Notes Amount
Building Permit Fee 322.10.00.00 $2.109.12
Building Plan Review Fee 345.83.00.00 $1.370.93
f-urnace 322.1U.UU.UU $25.0'
Gas Outlets Base Fee 1 to 5 322.10.00.0 $10.0
Mechanical Fee(Enter Fixture Fee) 322.10.00.0 $25.0
Mechanical Permit Base Fe 322.10.00.0 $25.0
Park-Cummunit S 345.85.00,01 $1.682.0
Plumbing Permit Base Fe 322.10.00.0 $25.0
Plumbing Permit Fee Enter Fixture Fee 322.10.00.0 11 $12 $132.0
Processing/Technology Fe 341.43.00.02 $25.0
State Building Code Surcharge Fe 386.00-01-00 $4.5
Traffic Mitigation 345.85 00 02 $3.355.0
Water Heater 322.10.00.0 $25.0
Totaq $8,793.5
Payments
Date Paid By Amount Description Payment Type I Accepted B
6/15/2017 1-GI Homes-Wdshin ton LLC $1.370,93 jgheck#4794 jKristin Foster
6/15/2017 ILGI Homes-Washington LLC $7,422,62 ICheck#4795 jKristin Foster
Total $8,793.55 Amount Outstanding:$0.0
Uploaded Files I Upload File
Date File Uploaded 8
6/15/2017 2:52:33 PM 1516 Site Plan.pdf Foster,Kristin x
6/15/2017 2:52:33 PM 1516 Applicationpdf Foster,Kristin �{
6/21/2017 LGI HOMES-WASHINGTON LLC
Search L&I Em
%,7.1 wh, 11016 Iv J tx
3arety-R Oairns& Insurance RinPd„ rad,�5�. �_irensiny
Washington State Department of
" Labor & Industries
LGI HOMES-WASHINGTON LLC
Owner or tradesperson 11410 NE 124 St Ste 103
LGI HOME GROUP LLC KIRKLAND,WA 98034
206-445-5326
Principals KING County
LGI HOME GROUP LLC, PARTNER/MEMBER
LIPAR, ERIC THOMAS, MANAGER
RSC CORPORATION,AGENT
WA UBI No. Business type
603 508 001 Limited Liability Company
License
Verity the contractor's active registration/license/certification(depending on trade)and any past violations.
Construction Contractor Active.
Meets current requirements.
License specialties
GENERAL
License no.
LGIHOHL857MB
Effective—expiration
07/02/2015—07/02/2019
Bond
International Fidelity Ins Co $12,000.00
Bond account no.
0657415
Received by L&I Effective date
07/02/2015 06/08/2015
Expiration date
Until Canceled
Insurance
AMTRUST INTERNATIONAL UNDERWRI $5,000,000.00
Policy no.
PAL127181500
Received by L&I Effective date
12/15/2016 12/01/2016
Expiration date
12/01/2017
Insurance history
gs
.Savin.............. ...
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 i-ielp us improve
https://secure.i ni.wa.gov/verify/D etai i.aspx?UBI=603508001&LIC=LGI H OH L857M B&SAW= 1/2
6/21/2017 LGI HOMES-WASHINGTON LLC
No L&I tax debts are recorded for this co :tor license during the previous 6 year period,but debts
may be recorded by other agencies.
License Violations
Infraction no.
ESCAH00464 Satisfied
Issue date RCW/WAC
02/17/2017 WAC 296-46B-990
Violation city Violation amount
KI RKLAND $500.00
Type of violation
ELECTRICAL CITATION
Description
Serious non-compliance-Serious Violation
(i.e. Installing a shortened rod/pipe
grounding electrode,improper splicing of
conductors in conduits/raceways or
concealed within walls or installing a fake
equipment grounding conductor or other non
conforming installation.)
Infraction no.
NDALS00763 Satisfied
Issue date RCW/WAC
12/16/2016 18.27.200(1)(b)RCW
Violation city Violation amount
KIRKLAND $500.00
Type of violation
CONSTRUCTION INFRACTION
Description
Advertising,offering to do work,submitting a
bid or performing work when the contractors
registration is suspended or revoked.
Workers' comp
No active workers'comp accounts during the previous 6 year period.
Workplace safety and health
No inspections during the previous 6 year period.
Washington State Dept.of_abor&Industries.Use of this site is subject to the laws of the state of Washington.
eir)us improve
hftps://secure.i ni.wa.gov/verify/Detai l.aspx?U BI=603508001&LIC=LGI H OH L857M B&SAW= 2/2
�-` l RESIDENTIAL PERMIT APPLICATION
Department of Community& Economic Development
IN
; City of Arlington • 18204 59th Ave NE•Arlington,WA 98223 • Phone(360)403-3551
THIS APPLICATION IS TO BE USED WHEN APPLYING FOR A NEW SINGLE-FAMILY, DUPLEX, TOWNHOUSE,
ADDITION,DECK,OR ACCESSORY STRUCTURES. THIS APPLICATION MUST BE ACCOMPANIED BY TWO(2)SETS
OF CONSTRUCTION DRAWINGS AND TWO(2)SETS OF STRUCTURAL CALCULATIONS. THE APPLICATION MUST
ALSO INCLUDE THE PLUMBING SUBMITTAL AND THE MECHANICAL SUBMITTAL FORMS. THE ZONING
VERIFICATION MAY BE SUBMITTED PRIOR.
Project Address: ���9 � � "� � r,� Plat: `_f 't0 2 L 5 b
1A Single-family Duplex ❑ Townhouse Addition ❑ /ccessory structure
Proposed Area: 11 Floor: �--Q�� 2nd Floor: Garage: Total SF:
Describe Proposal (include cross street):
!3W (() ��t_ z- (?- 4?0 pe5T-W /v(
Valuation: 4o-
Owner: L(�L1'"�� — �Ac Stti n1�zT� LLC_
Address: 1 t(7 A 1, IL- City: 1,f' State: Zip Code: 7--�
Phone: 2� '� Email:
Applicant: U-7 1�0111f� -"—3_A y z7b J
Address: 1/q/p �yf_ ,t -yr#S(—Al&city: State: Zip Code:
Phone: � �� Email: *ACOAt 5 Q(4/1 9. C't',
Contractor: L C' 1, tl d✓@—
Address: _�� � AR_ /;yf# S j ` 3 City: Li State: Zip Code:
Phone: r`� Email:
Contact Person:QLicense Number: d;714WZ-851t7 Expiration:
Received
6/16LP Page 1 of 3
a
i � �� L� .:
RESIDENTIAL PERMIT APPLICATION
Department of Community& Economic Development
City of Arlington • 18204 59th Ave NE •Arlington,WA 98223 • Phone(360)403-3551
Plumbing Section (continue filling out if plumbing is involved)
(Check all that apply and indicate the number of fixtures proposed)
6 Bath/Shower Combo (4.0) x J- Sink(1.5) x
Shower(2.0) x Lavatory(1.0) x
LA Clothes Washer(4.0) x ater Closet(2.5) x
[Z�,--Dishwasher(1.5) x + t�j—_Water Heater x
Hose Bibb (2.5) x Water Heater Model#
W—Other(list) x
Plumbing Section Continued
Proposed Water Piping Size: � � Proposed DWV Material:
Proposed Piping Material: �y— 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)
6/16LP Page 2 of 3
f
- - .
I
Y °�' RESIDENTIAL PERMIT APPLICATION
Department of Community& Economic Development
�ir,�GtO City of Arlington • 18204 59th Ave NE•Arlington,WA 98223 • Phone(360)403-3551
Mechanical Section (continue filling out if mechanical equipment is involved)
Select proposed appliances:
Furnace(80+) Model# AFUE X
Ql Heat Pump Model# SEER HSPE
Q� AC Unit Model# SEER
�1 Type II Hood ❑ Commercial Cooking Appliance [J] Hydronic Piping
❑ Boiler ❑ Solid-Fuel Appliance ❑ PV System
❑ Fireplace Insert ❑ Outdoor BBQ QI Storage Tank
Freestanding Stove ( Gas Piping ❑ Other
Gas Piping Information
Not Applicable: ❑
I
Pipe Material: T ipe Size: ( Total BTU's of all Appliances:
Distance from Meter to Furthest Appliance: ,- `7
• New gas piping requires a pressure test to 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 is required within 6 feet of all appliances
Applicant Signature: Date: ( �-
1
Print Applicants Name:
6/16LP Page 3 of 3
ar
Date: 04/09/2026
Permit#: 1516
Perm Date: 06/15/2017
Review Date: 06/15/2017
Perm Type: RESIDENTIAL SINGLE FAMILY
Review Type: RESIDENTIAL SINGLE FAMILY
Target Date: 06/22/2017
Scheduled Time 00:00
Com pleted Date: 06/15/2017
Description: Site plan m xts land use regulations.
Review Status:
Assigned To:
Tim eln: 00:00
Time O it: 00:00
H curs: 0.0
Property Information
Parcel#: 01166900005600 L GI HOMES -WASHINGTON LLC
LGI HOMES -WASHINGTON LLC 1 450 LAKE ROBBINS DR STE 430
8909 170th Street NE T HE WOODLANDS, TX 77380
Zoning: 111 Single Fam iy Residence -
DetachedLot: 56Block:
Permit#: 1516
Permit Date: 06/15/17
Permit Type: RESIDENTIAL SINGLE FAMILY
Project Nam e Gregory Park
Applicant Nam a LGI Horn cs -Washington, LLC
Applicant Address: 11410 NE 124th Street, Ste #103
Applicant, City, State, Zip: Kirkland,WA98033
Contact: Matt Adam s
Phone: 425-785-0797
Em al: m at.adam s@lgihom cs.com
Scope of Work: New SFR
Valuation: 187421.13
Square Feet: 1889
Num ber of Stories: 1
Construction Type:
O xupancy G ioup:
ID Code:
Permit Issued: 07/05/2017
Permit Expires:
Form Permit Type:
Status: LASERFICHE
Assigned To: Kristin Foster
Property
Parcel# Address L egal Description O wrier Nam e Ovner Phone Zoning
LGI HOMES-
01166900005600 8 909 170th Street NE WASHINGTON Residence
Single Dam iy
-Detached
LLC
Contractors
Contractor P rim ay Contact P hone A ddress C ontractor Type L icense License#
LGI HOMES- 12951 BELRED CONSTRUCTION Labor and LGIHOHL857MB
WASHINGTON LLC RD#150 CONTRACTOR Industries
Inspections
Date I nspection Type D escription S cheduled Date C om Iieted Date I nspector S tatus
09/06/2017 R20.SFR/DUPLEX Com Iieted
FINAL
Plan Reviews
Date R eview Type D escription A ssigned To R eview Status
RESIDENTIAL SINGLE
06/15/2017 FAMILY Site plan m its land use regulations.
06/15/2017 RESIDENTIAL SINGLE z.Rick Karns
FAMILY
Fees
Fee D escription N otes A m cunt
Building Perm i T able 4-1 $2,109.12
Building Plan Review T able 4-2 $1,370.93
Forced Air Heat f ee per Btu $25.00
Gas Piping/Units E nter#of units $10.00
Mechanical Fee(Enter Fixture Fee) $25.00
Mechanical Base P erm i Fee $25.00
Park-Com m nity SF S ingle Fam iy $1,662.00
Plum hng Base Perm i Fee $25.00
M echanical Com m mial Perm i T able 4-7;Per Unit I 1 @$12 $132.00
Processing/Technology $25.00
State Surcharge- 1 st DU R esidential- 1 st Unit $4.50
Traffic Mitigation-C/MF Orn m ecial/Multi-fam iy $3,355.00
Wier Heater(Tank) $25.00
Total $8,793.55
Attached Letters
Date Letter D escription
06/20/2017 Building Perm i
Paym acts
Date Paid By D escription P aym a►t Type A ccepted By A m cant
06/15/2017 LGI Hom cs-Washington Check#4795 K ristin Foster $7,422.62
LLC
06/15/2017 LGI Hom cs-Washington
Check#4794 K ristin Foster $1,370.93
LLC
O ttstanding Balance $0.00
Uploaded Files
Date File Nam e
07/10/2017 2432441-1516 Issued Perm i.pdf
06/15/2017 2372895-1516 Application.pdf
06/15/2017 2372896-1516 Site Plan.pdf