HomeMy WebLinkAbout9021 169th Street NE_BLD1655_2026 So ,*�
V ° RESIDENTIAL PERMIT APPLICATION
Department of Community&Economic Development
�471 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 BESUBMITTED PRIOR.
Project Address: /u� 11�✓� T-a -ST—1 E r IVY Plat: Z J46_'6_7 01z-i
Single-family Duplex IJ Townhouse J Addition Accessory structure
p st 1 � 2"d Floor: Garage: `t ��= Total SF:
Proposed Area: 1 Floor: � _7— f
Describe Proposal (include cross street):
g.
Valuation: I, a:onq
Owner: L& I �mrs P
Address: IlLfl0 L6� State: WAL Zip Code:
Phone: 42G•—Ptx� Email: fit. A &nn Ga L ho l' (QAA
Applicant: 4�AtAG A4-,, yWkt--
Address: City: State: Zip Code:
Phone: Email:
Contractor: A6Z VL�Lvi
Address: City: State: Zip Code:
Phone: CGS•� . ��� Email: /y►�'t"i: 1¢p 4 "I l�vwl�S. cgc 4
Contact Person: 1� t'I' ��11�S' License Number:L41114ok V(&Expiration: Z
Received
�, FP 14 2017
U2
6/16LP ICJ'
Page 1 of 3
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)
Bath/Shower Combo (4.0) x Sink(1.5) x
i Shower(2.0) x Lavatory(1.0) x
Clothes Washer(4.0) x Water Closet(2.5) x
Dishwasher(1.5) x Water Heater x
Hose Bibb (2.5) x Z Water Heater Model #
Other(list) x !� r
Plumbing Section Continued
Proposed Water Piping Size: Proposed DWV Material:
Proposed Piping Material: Proposed DWV Size: IL1
• 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
s'` RESIDENTIAL PERMIT APPLICATION
Department of Community& Economic Development
ur;c;,
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# �f?Y C f J)AG 3 5311K AFUE
❑ Heat Pump Model# SEER HSPE
❑ AC Unit Model # SEER
❑ Type II Hood [� Commercial Cooking Appliance ❑ Hydronic Piping
❑ Boiler QI Solid-Fuel Appliance ❑ PV System
❑ Fireplace Insert Q Outdoor BBQ ❑ Storage Tank
Freestanding Stove Gas Piping ❑ Other
Gas Piping Information
Not Applicable: Q�
Pipe Material: E L_ Pipe Size: L9 I Z� c�
p p �Total BTU's of all Appliances: � e)d
Distance from Meter to Furthest Appliance: 4()L
• 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
c
Applicant Signature: < 4-, Date: / L
Print Applicants Name: �rl
6/16LP Page 3 of 3
TERRA ASSOCIATES, Inc.
• •• Consultants in Geotechnical Engineering,Geology
and
Environmental Earth Sciences
FOOTING EXCAVATION OBSERVATION REPORT
DATE FOOTINGS OBSERVED: 11-15-17 PROJECT NO.: T-5753-5
PROJECT NAME: Stonebrook PROJECT LOCATION: Arlington, WA
CONTRACTOR: LGI Homes REPRESENTATIVE: Les
DESCRIPTION COVERED BY THIS REPORT: Foundation for lot 67
FOOTING EXCAVATION FIELD CONDITIONS NOTED
Approximately 6"deep Exposed at the bottom of the excavation we observed
dense brown silty sand with gravel.
Soils appear firm and compact.
NOTES: Soil conditions observed are consistent with those expected and are suitable for support of
foundations designed for an allowable bearing capacity of 2,500 pounds per square foot(psf).
Our representative has observed only the footing excavations listed above. The results of this observation are only
valid for a period of 48 hours. If any change in the subgrade occurs,we should be promptly notified.Any loosened
soils observed in foundation areas due to construction activity or rainfall should be removed prior to concrete
placement.
Kacel Swu.00' COPY TO:
SIGNATURE
Kacey Simon
TERRA ASSOCIATES REPRESENTATIVE
12220 - 113th Avenue NE, Suite 130, Kirkland, Washington, 98034 ♦ Telephone No. (425) 821-7777
7 CITY OF ARLINGTON
238 N. OLYMPIC AVE -ARLINGTON, WA. 98223
4D PHONE; (360)403-3551
BUILDING PERMIT
Address:9021 169th Street NE Permit#:1655
Parcel#:0 1166900006700 Valuation: 191174.89
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 98034 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-13
DWELLING UNITS: 1 OCC GROUP: R-3
BUILDINGS: 1 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 Arlington must be repo ed on your sales tax return forth
and c 0ity of rl' gton# 101.
�.� �I✓ use «�/ 10 d�I
/ Si ature Print Name Date Released 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
9/28/2017 Building Permit Fee $2,140.84
9/28/2017 Building Plan Review Fee $1,391.55
9/28/2017 Furnace $25.00
9/28/2017 Gas Outlets Base Fee 1 to 5 $10.00
9/28/2017 Mechanical Fee(Enter Fixture Fee) $25.00
9/28/2017 Mechanical Permit Base Fee $25.00
9/28/2017 Park-Community SF $1,662.00
9/28/2017 Plumbing Permit Base Fee $25.00
9/28/2017 Plumbing Permit Fee(Enter Fixture Fee) $132.00
9/28/2017 Processing/Technology Fee $25.00
9/28/2017 State Building Code Surcharge Fee $4.50
9/28/2017 Traffic Mitigation-City $3,355.00
9/28/2017 Water Heater $25.00
Total Due: $8,845.89
Total Payment: Su uo
Balance Due: 58,845.89
CALL FOR INSPECTIONS
BUILDING(360)403-3417
Whoa calling for an inspection please leave the following informatiow:
Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon
I SETBACKS NOTES,•
•a fROWT 20' •BU/LUNG DINN57GWS ARE TO
EA?577NG &DIF 5' FALL DID FOUNDA776v
REAR 5' •624DING 9VONN AS"6W_ (7)P.) R ° ACTUAL LOCAAaIV MAY VARY
•SYL)'E DR/WWAY lit PUU410 ROAD
•_%T fENLX TO 8E INSTALLED PER
aT r OIL ARL/NG77W S STANDARD
•57LT fENCr M BE INSTALLED GW
— — — — -- — — — — — — ld4ADIENT SrDE(F BUILDING
N8920'49"W PARLLZ
— — — — — $ — — 50.00 — •CLWS7RUCIJDW EN7RAKr MBE
_ _ INSTALLED PER a7r or
7 T ARL/NGrWF STANDARDS
GLYPNEIPPi'LVER7Y I � 5 B,Si9L °
STORM NOTES.-
(�J I 24.50 $ 20' •7EX INSTALLED PRIOR TO
WATER 1 C0VSDPUC77aV
•BARE SOILS COWRED N/7H MULal
R7NI-W0 CONMUR PAAO 12 SF SLRN I X AN07HER APPRO10 BMP
� � I 5'B.SK •7WSOIL PER N506f bW 7513
PROOF ROCF I 10.50 ,� aV.77E OIT COVNECIED TO
Ot£PHANG aW
0 0 l PR/VA7F STLAPM SNUB
$ LOT 67 a o o, C! •SrTF SHALL BE STAL7/L/ZED AWOR
P,?Ovsm IPE,Aawa- ^ o 70 BU/LDYNG PDwr BEING
CaUMBIA-1487 WAX LEFT RNAU20
2,109fY $ SITENOTES.•
�, 8 Q •AL YNJNE f007ING DRAINS AND
ROOF DRAINS M PERMANENT
WAX I OY I LUNZINE d STt�PM DRA/NAar SY57LV POP
APPRowD PLAT DRAINAGE PLAN
Lao/RLE W7H 7HE CWNTY.
•AREA OF D/S7URB IX INLYUDES
I 4.25 $ ENARELOT.
$ v
10,PUBLIC I 1 .75 v $ 11.00 LEGEND:
U77L/TY I r LN 16 S)AY ° BLOW OFF
EASEUENT
— — — — 4 1 ® WA7FR A/E7DP
« f7/PE HYDRANT
0' °27', .0 AIR VAC
093 CA7W BAMN
' p O GYEANOIUT
25.00 d O MANHOLE
N8920'49"W \° 111 ® &
S7ta4M!LX�NOUT. �}
aWNECT ROLL A 1RE1�REMOVALN '" j-
f0077NG DRAINS
169 ST. NE \ r'eece1veo
8'SENDP SOME I'm 20'
1 LOT 67
SITE PLAN
I d '� y n v� �l
GREGOR Y RA RK
LGI HOMES PLAN NO. COL.—1487
HOUSE= 2, 09
LOT AREA = ,,109 SF SF DATE 812312017 PARCEL # LOT 67
1471 I NE 29Hr Place,N I01
DRIWWAY= 516 SF 8,11,,ue,W,,higl,,98007 DESIGNED CORE ADDRESS 9021 1697H ST.
425.885.7877 Fax 425.865.7963
WALKWAY/PAnO = 12 SF ��°Eslerv' PROJECT NUMBER
TOTAL= 2,637 SF
ENGINEERING PLANNING • SURVEYING DRAWN CAF 13024L-GRG00
i
TERRA ASSOCIATES, Inc.
• ••• Consultants in Geotechnical Engineering,Geology
and
Environmental Earth Sciences
FOOTING EXCAVATION OBSERVATION REPORT
DATE FOOTINGS OBSERVED: 11-15-17 PROJECT NO.: T-5753-5
PROJECT NAME: Stonebrook PROJECT LOCATION: Arlington, WA
CONTRACTOR: LGI Homes REPRESENTATIVE: Les
DESCRIPTION COVERED BY THIS REPORT: Foundation for lot 67
FOOTING EXCAVATION7 FIELD CONDITIONS NOTED
Approximately 6" deep Exposed at the bottom of the excavation we observed
dense brown silty sand with gravel.
Soils appear firm and compact.
NOTES: Soil conditions observed are consistent with those expected and are suitable for support of
foundations designed for an allowable bearing capacity of 2,500 pounds per square foot(psf).
Our representative has observed only the footing excavations listed above.The results of this observation are only
valid for a period of 48 hours. If any change in the subgrade occurs,we should be promptly notified.Any loosened
soils observed in foundation areas due to construction activity or rainfall should be removed prior to concrete
placement.
Kace� 5i,wt0V" COPY TO:
SIGNATURE VA?iVSS ;
Kacey
_TERR Simon qW1 I �f 5�Jjj
TERRA ASSOCIATES REPRESENTATIVE LP�II�
12220 - 113th Avenue NE, Suite 130, Kirkland, Washington, 98034 ♦ Telephone No. (425) 821-7777
CITY OF ARLINGTON
238 N. OLYMPIC AVE -ARLINGTON, WA. 98223
__ .— PHONE; (360)403-3551
BUILDING PERMIT
Address:9021 169th Street NE Permit#:1655
Parcel#:01166900006700 Valuation:191174.89
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 98034 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: V-B
DWELLING UNITS: I OCC GROUP: R-3
BUILDINGS: I 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.
SAL T>,X NOTICE:Sales tax relating to construction and construction materials in the City of Arlington must be repo ed on your sales tax return form
and c City of rl' gton# 101.
l� *.� r 1// ro a i r
Si ture Print Name Date Released 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
9/28/2017 Building Permit Fee $2,140.84
9/28/2017 Building Plan Review Fee $1,391.55
9/28/2017 Furnace $25.00
9/28/2017 Gas Outlets Base Fee 1 to 5 $10.00
9/28/2017 Mechanical Fee(Enter Fixture Fee) $25.00
9/28/2017 Mechanical Permit Base Fee $25.00
9/28/2017 Park-Community SF $1,662.00
9/28/2017 Plumbing Permit Base Fee $25.00
9/28/2017 Plumbing Permit Fee(Enter Fixture Fee) $132.00
9/28/2017 Processing/Technology Fee $25.00
9/28/2017 State Building Code Surcharge Fee $4.50
9/28/2017 Traffic Mitigation-City $3,355.00
9/28/2017 Water Heater $25.00
Total Due: $8,845.89
Total Payment: $0.00
Balance Due: $8.845.89
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
Permit Information
Date 9/15/2017
Permit Number 1655
Project Name Gregory Park
Applicant Name LGI Homes-Washington, LLC
Applicant Address 11410 NE 124th Street,Ste#103
City,State,Zip Kirkland,WA 98034
Contact Matt Adams
Phone 425-785-0797
Email matt.adams@lgihomes.com
Permit Type Single Family Residence
Site Address 9021 169th Street NE
Valuation 191174.89
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#:01166900006700 LGI HOMES-WASHINGTON LLC
LGI HOMES-WASHINGTON LLC 1450 LAKE ROBBINS DR STE 430
9021 169th Street NE THE WOODLANDS,TX 77380
Contractors
Contractor Name Primary Phone Email Contractor License License#
Contact Type
ILGI Homes-Washington, 360-353- Labor and
ILLC Jake Jabusch ,D588 ake.jabusch@lgihomes.co CONTRACTOR lindustries I-GIHOHL857M
Review
Date Type Description I Target Date Completed Date I Assigned To I Status
3/15/2017 lResidential Dwelling 9/22/2017 fkmy Rusko 11in Review
-I/15/2017 lResidential Dwelling 9/22/2017 (Rick Karns 111n Review
Fees
Fee Description Notes Amount
Building Permit Fee 322.10.00.0 $2,140.84
Building Plan Review Fee 345.83.00.0 $1.391.5
Furnace 322.10.00.00 $25.0
Gas Outlets Base Fee 1 to 5 322.10.00.0 $10.0
Mechanical Fee(Enter Fixture Fee) 322.10.00.00 $25.00
Mechanical Permit Base Fee 322.10.00.0 $25.0
Park-Community SF 345.85.00.0 $1.662.0
Plumbing Permit Base Fee 322.10.00.0 $25.00
Plumbinq Permit Fee(Enter Fixture Fee 322.10.00.0 11 @$12 $132.0
Process in /Tech nolog y Fee 341.43.00.02 $25.0
State BuildingCode Surcharge Fee 386.00.01.0 $4.50
Traffic Mitigation-Cit 345.85.00.02 $3,355.0
Water Heateil 322.10.00.0 $25.00
Total $8,845.8
Notes
Date Note
9/15/2017 Columbia-Lot 67
Uploaded Files Upload File
Date File Uploaded B
9/15/2017 11:31:29 AM 1655 Site Plan.�df Foster,Kristin }(
9/15/2017 11:31:29 AM 1655 Applicatio. n.pdf Foster.Kristin x
RESIDENTIAL PERMIT APPLICATION
.y Department of Community&Economic Development
�l City of Arlington • 18204 59th Ave NE•Arlington,WA 98223 • Phone (360)403-3551
JNG
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 BESUBMITTED PRIOR.
Project Address: / lo� -Srifefr ME Plat: Z 6 C7C0IZI 1r`
Single-family J Duplex ❑ Townhouse ❑ Addition ❑ Accessory structure
Proposed Area: 1 st Floor: r'l 2"d Floor: Garage: �d2_Total SF: JW
Describe Proposal (include cross street):
Valuation:
Owner:
Address: 0 kh/_1 1� C,'(1 1 �( ity: State: Wk Zip Code: c o�
Phone: 42G •7tbS. Email:
ti
Applicant: air kzz 7y
Address: City: State: Zip Code:
Phone: Email:
Contractor: i�S''1f�
Address: II IImo�... City: A State: Zip Code:
Phone: CGS•' . ��'l Email: /v kffi 4VAR4J & L61 4t44,J-S C.►W
Contact Person: PM 4TT- "S License Number:LLrl(4okh GLt?,Expiration: Z
Received
6/16LP U2 RF�
Page 1 of 3
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1....�• �� � � �.`�.
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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)
Bath/Shower Combo (4.0) x I Sink(1.5) x
Shower(2.0) x Lavatory(1.0) x
❑ Clothes Washer(4.0) x ' Water Closet(2.5) x Z
Dishwasher(1.5) x Water Heater x i
Hose Bibb (2.5) x Water Heater Model#
Other(list) x
Plumbing Section Continued
it
Proposed Water Piping Size: Proposed DWV Material: Q�
Proposed Piping Material: -`N Proposed DWV Size: �1
• 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)
6I16LP Page 2 of 3
e�Y , RESIDENTIAL PERMIT APPLICATION
Department of Community& Economic Development
'Ql jjN 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# U AFUE
Heat Pump Model# SEER HSPE
AC Unit Model # SEER
Type II Hood ❑ Commercial Cooking Appliance ❑ Hydronic Piping
❑ Boiler Ql Solid-Fuel Appliance UI PV System
Fireplace Insert U Outdoor BBQ ❑ Storage Tank
Freestanding Stove Gas Piping ❑ Other
Gas Piping Information
Not Applicable: Q
Pipe Material: '.;X_FILL_ Pipe Size: Total BTU's of all Appliances: �
Distance from Meter to Furthest Appliance: �L
• 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: _ i#o -4�4z Date: S �Z
Print Applicants Name: 4-t-7
6/16LP Page 3 of 3
' -1
Date: 04/10/2026
Permit#: 1655
Permit Date: 09/15/2017
Review Date: 09/15/2017
Perm it Type: RESIDENTIAL SINGLE FAMILY
Review Type: RESIDENTIAL SINGLE FAMILY
Target Date: 09/22/2017
Scheduled Time 00:00
Com pleted Date: 09/15/2017
Description: Site plan m xts setback requirem mts.
Review Status:
Assigned To:
Tim eIn: 00:00
Time O it: 00:00
H curs: 0.0
Property Information
Parcel#: 01166900006700 L GI HOMES -WASHINGTON LLC
LGI HOMES -WASHINGTON LLC 1 450 LAKE ROBBINS DR STE 430
9021 169th Street NE T HE WOODLANDS, TX 77380
Zoning: 111 Single Fam iy Residence -
DetachedLot: 67Block:
Permit#: 1655
Permit Date: 09/15/17
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,WA98034
Contact: Matt Adam s
Phone: 425-785-0797
Em al: m at.adam s@lgihom cs.com
Scope of Work: New SFR
Valuation: 191174.89
Square Feet: 1889
Num ber of Stories: 1
Construction Type:
O xupancy G ioup:
ID Code:
Permit Issued: 10/11/2017
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-
01166900006700 9 021 169th 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
11/14/2017 R20.SFR/DUPLEX 02/21/2018 C omlieted
FINAL
Plan Reviews
Date R eview Type D escription A ssigned To R eview Status
RESIDENTIAL SINGLE
09/15/2017 FAMILY Site plan m e is setback requirem sits.
09/15/2017 RESIDENTIAL SINGLE z.Rick Karns
FAMILY
Fees
Fee D escription N otes A m amt
Building Perm i T able 4-1 $2,140.84
Building Plan Review T able 4-2 $1,391.55
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-SF S ingle Fam iy $3,355.00
Wier Heater(Tank) $25.00
Total $8,845.89
Attached Letters
Date Letter D escription
09/28/2017 Building Perm i
Paym acts
Date Paid By D escription P aym a►t Type A ccepted By A m aunt
10/02/2017 LGI Hom e; c heck#5565 L auna Black $1,391.55
10/02/2017 LGI Hom e; c heck#5566 L auna Black $7,454.34
O utstanding Balance $0.00
Notes
Date Note C reated By:
09/15/2017 Colum ha-Lot 67 K ristin Foster
Uploaded Files
Date File Nam e
11/20/2017 2788755-1655 Footing Excavation Report.pdf
10/11/2017 2692552-1655 Issued Perm i.pdf
09/15/2017 2607807-1655 Application.pdf
09/15/2017 2607808-1655 Site Plan.pdf