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HomeMy WebLinkAbout17216 51st Ave Ne Ste 114_BLD6178_2025 Permit Packet Coversheet Community and Economic Development City of Arlington • 18204 59th Avenue NE • Arlington, WA 98223 • Phone (360) 403-3551 Page 1 of 1 Permit Number: Permit Type: Address/Parcel: Completed (Month/Year): Land Use ˆ Notice of Decision ˆ Staff Report ˆ Application ˆ Narrative ˆ Legal Description ˆ Vicinity Map ˆ Site Plan ˆ Landscape Plan ˆ Complete Streets Checklist ˆ Traffic Impact Analysis ˆ Snohomish County Traffic Mitigation Offer ˆ WSDOT Traffic Offer Form ˆ Tree Survey ˆ Stormwater Drainage Report ˆ Geotech Report ˆ Critical Area Evaluation Form ˆ SEPA Checklist ˆ Public Notice Material ˆ Noticing and Related Documents ˆ Water / Sewer Availability Certificate ˆ Unanticipated Discovery Plan Form ˆ Aerial Photo of Site ˆ Proposed Building Materials ˆ Lighting Plans and Lighting Cut Sheets ˆ Color Elevations ˆ Design Matrix ˆ Plat Map ˆ Title Report ˆ Lot Closures ˆ Preliminary Civil Plans ˆ Archaeological Survey o Confidential Documents. Contact the City to obtain. ˆ Topography (Existing Conditions) ˆ CC&R’s ˆ Deeds / Easements / Conveyances /Dedications ˆ Developer’s Agreement ˆ Recorded Copies ˆ Bonding or Assignment of Funds o Confidential Documents. Contact the City to obtain. ˆ Letters and Project Documents ˆ Other: Civil ˆ Issued Permit ˆ Application ˆ Other Applications ˆ Construction Calculation Worksheet ˆ Approved Plans ˆ Review Comment Form ˆ Letters and Project Documents ˆ Other Agency Permits ˆ Reports: o Drainage Report Pg: o Stormwater Pg: o Geotech Pg: o All Other Reports ˆ SEPA and Noticing Materials ˆ Inspections ˆ As-Builts ˆ Other: Building ˆ Issued Permit ˆ Application ˆ Additional Applications ˆ Approved Plans ˆ Site Plan ˆ Letters and Project Documents ˆ Calculations ˆ Project Specification Manuals ˆ Reports ˆ Certificate of Occupancy ˆ Inspections ˆ Other: BLD6178 Commercial Alteration 17216 51st Ave Ne Ste 114 January 2025 ✔ ✔ ✔ ✔ COMMERCIAL TENANT IMPROVEMENT PERMIT APPLICATION Community and Economic Development City of Arlington • ͳͺʹͲͶͷͻ–Š˜‡Ȉ”Ž‹‰–‘ǡͻͺʹʹ͵ȈŠ‘‡ȋ͵͸ͲȌͶͲ͵Ǧ͵ͷͷͳ Š‡ˆ‘ŽŽ‘™‹‰‹ˆ‘”ƒ–‹‘‹•”‡“—‹”‡†ˆ‘”‘‡”…‹ƒŽǡ—Ž–‹Ǧ ƒ‹Ž›ǡƒ†‹š‡†Ǧ•‡—‹Ž†‹‰‡”‹–’’Ž‹…ƒ–‹‘•Ǥ ƒ”‡ƒ…Š„‘š–‘†‡•‹‰ƒ–‡–Šƒ––Š‡‹ˆ‘”ƒ–‹‘Šƒ•„‡‡’”‘˜‹†‡†ǤŽ‡ƒ•‡•—„‹––Š‹•…Š‡…Ž‹•–ƒ•’ƒ”–‘ˆ–Š‡ •—„‹––ƒŽ†‘…—‡–•ǤSee ASSISTANCE BULLETIN #30 for detailed design requirements. EACH BUILDING OR STRUCTURE REQUIRES A SEPARATE SUBMITTAL.           ǢIncomplete applications will not be accepted. ͳǤ Žƒ‡˜‹‡™ˆ‡‡‹•†—‡ƒ––‹‡‘ˆ•—„‹––ƒŽƒ†”‡ƒ‹‹‰„ƒŽƒ…‡™‹ŽŽ„‡†—‡ƒ––‹‡‘ˆ‹••—ƒ…‡Ǥ ʹǤ Š‡‹–›‘ˆ”Ž‹‰–‘†‘‡•‘–”‡˜‹‡™‘”‹•’‡…–‡Ž‡…–”‹…ƒŽ•›•–‡•Ǥ‘–ƒ…–ƒ„‘”ƒ† †—•–”‹‡•ƒ–Ž‹Ǥ™ƒǤ‰‘˜‘” ͵͸ͲǦͶͳ͸Ǧ͵ͲͲͲǤ A. DEFERRED SUBMITTALS ˆ–Š‡’”‘Œ‡…–”‡“—‹”‡•ƒ›‘ˆ–Š‡ˆ‘ŽŽ‘™‹‰ǡƒ‡ˆ‡””‡†—„‹––ƒŽ‡“—‡•–„‡…‘’Ž‡–‡†Ǥ‡ˆ‡””‡†•—„‹––ƒŽ•”‡“—‹”‡ •‡’ƒ”ƒ–‡ƒ’’Ž‹…ƒ–‹‘•ǡ’Žƒ•ƒ†’Žƒ”‡˜‹‡™Ǥ ͳǤ ‡…Šƒ‹…ƒŽŽƒ•ȋ‹ˆ‘–‹…Ž—†‡†‹–Š‡’Žƒ•‡–Ȍ ʹǤ Ž—„‹‰Žƒ•ȋ‹ˆ‘–‹…Ž—†‡†‹–Š‡’Žƒ•‡–Ȍ ͵Ǥ ‹”‡’”‹Ž‡” ͶǤ ‹”‡Žƒ” ͷǤ ‹‰ƒ‰‡ B. SPECIAL INSPECTION AND TESTING AGREEMENT ’‡…‹ƒŽ •’‡…–‹‘ ‹”‹•”‡“—‹”‡†–‘’‡”ˆ‘”•’‡…‹ƒŽ‹•’‡…–‹‘•ˆ‘”–Š‡ˆ‘ŽŽ‘™‹‰–›’‡‘ˆ™‘”Ǥ ȗŠ‡’‡…‹ƒŽ •’‡…–‹‘ƒ†‡•–‹‰‰”‡‡‡–„‡•—„‹––‡†™‹–Š–Š‡—‹Ž†‹‰’’Ž‹…ƒ–‹‘Ǥ ‡‹ˆ‘”…‡†‘…”‡–‡–”—…–—”ƒŽ–‡‡Žƒ†‡Ž†‹‰ ‘Ž–‹‰‹‘…”‡–‡ ‹‰ŠǦ–”‡‰–Š‘Ž–‹‰ ”‡Ǧ•–”‡••‡†‘…”‡–‡’”ƒ›Ǧ’’Ž‹‡† ‹”‡’”‘‘ˆ‹‰ Š‘–…”‡–‡‘‡Ǧ‘–”‘Ž›•–‡• –”—…–—”ƒŽƒ•‘”›–Š‡”Ǧ’‡…‹ˆ›ǣ̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴ I acknowledge that all items designated as submittal requirements must accompany my Tenant Improvement Permit Application to be considered a complete submittal. REQUIRED DOCUMENTS ‹–›‘ˆ”Ž‹‰–‘‘‡”…‹ƒŽ‡ƒ– ’”‘˜‡‡–‡”‹–’’Ž‹…ƒ–‹‘ ‹–‡Žƒ ”…Š‹–‡…–—”ƒŽŽƒ• –”—…–—”ƒŽŽƒ• –”—…–—”ƒŽƒŽ…—Žƒ–‹‘• ‡…Šƒ‹…ƒŽ›•–‡‘†‹ˆ‹…ƒ–‹‘•ǡ(if applicable) Ž—„‹‰›•–‡‘†‹ˆ‹…ƒ–‹‘•ǡ(if applicable) ”‘Œ‡…–’‡…‹ˆ‹…ƒ–‹‘ƒ—ƒŽ•ǡ(if applicable) ‘’Ž‹ƒ…‡ ‘”•ǡ(if applicableȌŠ––’•ǣȀȀ™ƒ‡‡”‰›…‘†‡•Ǥ…‘Ȁ ’‡…‹ƒŽ •’‡…–‹‘ƒ†‡•–‹‰‰”‡‡‡– ‡ˆ‡””‡†—„‹––ƒŽ‡“—‡•– ‹”’‘”–”‘’‡”–›‡ƒ•‡ȋ‹ˆ„—‹Ž†‹‰‹•Ž‘…ƒ–‡†™‹–Š‹–Š‡”Ž‹‰–‘‹”’‘”–”‘’‡”–›‘—†ƒ”›Ȍ ✔ ✔ ✔ ✔ ✔ ✔ COMMERCIAL TENANT IMPROVEMENT Ͳ͵ǤʹͲʹʹƒ‰‡ʹ‘ˆ͹ INSTALLATION, MODIFICATION OR REMOVAL MAY REQUIRE A SEPARATE PERMIT SUBMITAL *CHECK ALL THAT APPLY —–‘ƒ–‹…ˆ‹”‡‡š–‹‰—‹•Š‹‰•›•–‡•‘’”‡••‡†‰ƒ••›•–‡• ‹”‡’—’• Žƒƒ„Ž‡ƒ†…‘„—•–‹„Ž‡Ž‹“—‹†•ȋ–ƒ•ǡ’‹’‹‰‡–…ǤȌ –ƒ†’‹’‡•›•–‡• ƒœƒ”†‘—•ƒ–‡”‹ƒŽ• ”‹˜ƒ–‡ˆ‹”‡Š›†”ƒ–• †—•–”‹ƒŽ‘˜‡•Ȁˆ—”ƒ…‡ ‹”‡ƒŽƒ”ƒ††‡–‡…–‹‘•›•–‡•’”ƒ›‹‰‘”†‹’’‹‰‘’‡”ƒ–‹‘• ‹‰Š’‹Ž‡†Ȁ”ƒ…•–‘”ƒ‰‡‡’‘”ƒ”›‡„”ƒ‡•–”—…–—”‡ǡtents (>200 sq. ft.) or canopies (>400 sq. ft.) ”‘˜‹†‡†‡–ƒ‹Ž•‘ƒ›‘ˆ–Š‡ƒ„‘˜‡…Š‡…‡†‹–‡•ǣ ̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴ BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB Type of Permit: ‡™’ƒ…‡††‹–‹‘Ž–‡”ƒ–‹‘ ”‘’‡”–›††”‡••ǣ ”‘Œ‡…–ƒŽ—ƒ–‹‘ǣ ‘–͓ǣ  ƒ”…‡Ž ‘Ǥǣ  —„†‹˜‹•‹‘ǣ ”‘Œ‡…–…‘’‡‘ˆ‘”ǣ ‡•…”‹’–‹‘‘ˆ‡™‡ƒ–—•‹‡••’‡”ƒ–‹‘•ǣ ‘•–”—…–‹‘›’‡ǣ ……—’ƒ…››’‡ǣ —‹Ž†‹‰Ȁ’ƒ…‡“—ƒ”‡ ‘‘–ƒ‰‡ǣ —„‡”‘ˆ–‘”‹‡•ǣ “—ƒ”‡ ‘‘–ƒ‰‡‡” Ž‘‘”ǣ ͳ•– ʹ† ͵”† Ͷ–Š ͷ–Š ͸–Š ”‹ƒ”›‘–ƒ…–ǣ™‡””…Š‹–‡…–‰‹‡‡”‘–”ƒ…–‘” ™‡”ƒ‡ǣ ˆˆ‹…‡‘Ǥǣ ƒ‹Ž††”‡••ǣ ‡ŽŽ‘Ǥǣ ƒ‹Ž‹‰††”‡••ǣ ‹–›ǣ –ƒ–‡ǣ ‹’ǣ ”…Š‹–‡…–ƒ‡ǣ ˆˆ‹…‡‘Ǥǣ ƒ‹Ž††”‡••ǣ ‡ŽŽ‘Ǥǣ ƒ‹Ž‹††”‡••ǣ ‹–›ǣ –ƒ–‡ǣ ‹’ǣ ”‘ˆ‡••‹‘ƒŽ‹…‡•‡—„‡”ǣ š’‹”ƒ–‹‘ƒ–‡ǣ ‰‹‡‡”ƒ‡ǣ ˆˆ‹…‡‘Ǥǣ ƒ‹Ž††”‡••ǣ ‡ŽŽ‘Ǥǣ ƒ‹Ž‹‰††”‡••ǣ ‹–›ǣ –ƒ–‡ǣ ”‘ˆ‡••‹‘ƒŽ‹…‡•‡—„‡”ǣ š’‹”ƒ–‹‘ƒ–‡ǣ ”‹ƒ”›‘–”ƒ…–‘”ǣ ˆˆ‹…‡‘Ǥǣ ƒ‹Ž††”‡••ǣ ‡ŽŽ‘Ǥǣ ƒ‹Ž‹††”‡••ǣ ‹–›ǣ –ƒ–‡ǣ ‹’ǣ Ƭ ‘–”ƒ…–‘”‹…‡•‡—„‡”ǣ š’‹”ƒ–‹‘ƒ–‡ǣ ✔  VW $YH 1(  &RQVWUXFWGRFNOHYHOHUSLWVIRU  GRFNOHYHOHUVDWORDGLQJGRFN 1&6 1DWLRQDO &DUZDVK 6ROXWLRQV ,,,%% 6 +   6PDUWFDS $UOLQJWRQ $LUSRUW ,QGXVWULDO 3DUN 42=% //& FKULV#WKHVPDUWFDSJURXSFRP    WK $YH 1( 6XLWH 5HGPRQG :$ /DQFH 0XHOOHU $VVRFLDWHV  KDUROGF#OPXHOOHUFRP  /DNHVLGH 6XLWH 6HDWWOH :$ 3 (QJLQHHUV 1RUWKZHVW ,QF 36 MRDQQHE#HQJLQHHUVQZFRP  UG $YH : 6XLWH /\QQZRRG  ‹’ ǣ 'DYLV 6FKXHOOHU ,QF FVWRFNEXUJHU#GDYLVVFKXHOOHUFRP   &KHQQDXOW %HDFK 5G 6XLWH 0XNLOWHR :$ '$9,66,31  COMMERCIAL TENANT IMPROVEMENT Ͳ͵ǤʹͲʹʹƒ‰‡͵‘ˆ͹ MECHANICAL SYSTEM INFORMATION x‡™‰ƒ•’‹’‹‰”‡“—‹”‡•ƒ’”‡••—”‡–‡•–Š‘‘‹‰–‘ƒ›ƒ’’Ž‹ƒ…‡ x‡†‹‡––”ƒ’•ȋ†”‹’•Ȍƒ”‡”‡“—‹”‡†‘ƒŽŽ‰ƒ•Ž‹‡• x ƒ•Ž‹‡•ƒ”‡”‡“—‹”‡†–‘„‡•—’’‘”–‡†Ȁ•‡…—”‡†’‡” ǡ‡…–‹‘Ͷͳͷ x”‘’‡”‘„—•–‹‘ƒ‹”ƒ†˜‡–‹‰”‡“—‹”‡†ˆ‘”ƒŽŽƒ’’Ž‹ƒ…‡• x•Š—–Ǧ‘ˆˆ˜ƒŽ˜‡‹•”‡“—‹”‡†™‹–Š‹͸ˆ‡‡–‘ˆ‡ƒ…Šƒ’’Ž‹ƒ…‡ MECHANICAL PERMIT FEES (per unit) Type of Fixture No. of Units Cost per Unit Subtotal ††‹–‹‘ƒŽŽƒ‡˜‹‡™ˆ‡‡• š ̈́͹ͷǤͲͲ α ̈́ ‹”‘†Ǥ‹–ζͳͲͲ–—ȀŠ š̈́ͳͷǤͲͲ α̈́ ‹”‘†Ǥ‹–εͳͲͲ–—ȀŠ š̈́ʹͷǤͲͲ α̈́ ‹”‘†Ǥ‹–εͷͲͲ–—ȀŠ’ š̈́ͷͲǤͲͲ α̈́ ‹” ƒ†Ž‹‰‹–• š̈́ͳͷǤͲͲ α̈́ ƒ•‡‡…Šƒ‹…ƒŽ ‡‡ ̈́ʹͷǤͲͲ ̈́ʹͷǤͲͲ ‘‹Ž‡”δͳͲͲ–—ȀŠε͵Š’ š̈́ͳͷǤͲͲ α̈́ ‘‹Ž‡”εͳ‹ŽŽ‹‘–—ȀŠδͷͲŠ’ š̈́ʹͷǤͲͲ α̈́ ‘‹Ž‡”εͳǤͷ‹ŽŽ‹‘–—ȀŠδͷͲŠ’ š̈́ͷͲǤͲͲ α̈́ ‘‹Ž‡”εͳͲͲ–—ȀŠ͵ǦͳͷŠ’ š̈́ͳͷǤͲͲ α̈́ ‘‹Ž‡”εͷͲͲ–—ȀŠͳͷǦ͵ͲŠ’ š̈́ʹͷǤͲͲ α̈́ ‘‡”…‹ƒŽ ‘‘†•Ǧ›’‡  š̈́ʹͷǤͲͲ α̈́ ‘‡”…‹ƒŽ ‘‘†•Ǧ›’‡  š ̈́ͷͲǤͲͲ α ̈́ ‹ˆˆ—•‡”• š̈́ͳͷǤͲͲ α̈́ ”›‡”—…–‹‰ š̈́ͳͷǤͲͲ α̈́ —…–™‘”ȋ†”ƒ™‹‰•”‡“—‹”‡†Ȍ š̈́ʹͷǤͲͲ α̈́ ˜ƒ’‘”ƒ–‹˜‡‘‘Ž‡”• š̈́ͳͷǤͲͲ α̈́ šŠƒ—•–Ȁ‡–‹Žƒ–‹‘ ƒ• š̈́ͳͷǤͲͲ α̈́ ‹”‡’Žƒ…‡Ȁ •‡”–Ȁ–‘˜‡ š̈́ͳͷǤͲͲ α̈́ ‘”…‡†‹” ‡ƒ–ζͳͲͲ–—ȀŠ š̈́ͳͷǤͲͲ α̈́ ‘”…‡†‹” ‡ƒ–εͳͲͲ–—ȀŠ š̈́ʹͷǤͲͲ α̈́ ƒ•Ž‘–Š‡•”›‡” š̈́ͳͷǤͲͲ α̈́ ƒ• ‹”‡†ζͳͲͲ–—ȀŠ š̈́ͳͷǤͲͲ α̈́ Type of Permit: ˆ ‡™ •–ƒŽŽƒ–‹‘ˆ ††‹–‹‘ˆŽ–‡”ƒ–‹‘ˆ‡’Žƒ…‡†ˆ ƒ•‹’‹‰ ‡…Šƒ‹…ƒŽ‘–”ƒ…–‘”ǣ  ˆˆ‹…‡‘Ǥǣ ƒ‹Ž††”‡••ǣ ‡ŽŽ‘Ǥǣ ƒ‹Ž‹‰††”‡••ǣ  ‹–›ǣ –ƒ–‡ǣ ‹’ǣ Ƭ ‘–”ƒ…–‘”‹…‡•‡—„‡”ǣ š’‹”ƒ–‹‘ƒ–‡ǣ Gas Piping Specification and complete Schematic PAGE 4 ˆ‘–’’Ž‹…ƒ„Ž‡ ”‘’‘•‡†‹’‹‰ƒ–‡”‹ƒŽǣˆˆ”ƒ••ˆŽƒ…–‡‡Žˆ ƒŽ˜ƒ‹œ‡†–‡‡Žˆ–Š‡” ”‘’‘•‡†‹’‹‰‹œ‡ǣˆΦdzˆ᪨dzˆΧdzˆͳdzˆͳΦdzˆʹdz Ž‡–”‡••—”‡ǣ ”‡••—”‡”‘’ǣ ’‡…‹ˆ‹… ”ƒ˜‹–›ǣ COMMERCIAL TENANT IMPROVEMENT Ͳ͵ǤʹͲʹʹƒ‰‡Ͷ‘ˆ͹ MECHANICAL PERMIT FEES (per unit) ƒ• ‹”‡†εͳͲͲ–—ȀŠ š̈́ʹͷǤͲͲ α̈́ ƒ• ‹”‡†εͷͲͲ–—ȀŠ š̈́ͷͲǤͲͲ α̈́ ƒ•‹’‹ζͷ—‹–• š̈́ͳͷǤͲͲ α̈́ ƒ•‹’‹‰εͷ—‹–•ȋ’Ž—•δͷ—‹–•Ȍ š̈́ʹǤͲͲ α̈́ ‡ƒ–š…Šƒ‡”• š̈́ͳͷǤͲͲ α̈́ ‡ƒ–—’Ǧ‘†‡•‹‹– š̈́ʹͷǤͲͲ α̈́ ‘–ƒ–‡” ‡ƒ–‘‹Ž• š̈́ͳͷǤͲͲ α̈́ ‹•…‡ŽŽƒ‡‘—•’’Ž‹ƒ…‡Ǧ”‡‰—Žƒ–‡†„› ‡…Šƒ‹…ƒŽ…‘†‡ǡ‘–‘–Š‡”™‹•‡•’‡…‹ˆ‹‡†š̈́ͳͷǤͲͲα̈́ Ǥ‹–•ζͳͲͲ„–— š̈́ʹͷǤͲͲ α̈́ Ǥ‹–•εͳͲͲ„–— š̈́ͷͲǤͲͲ α̈́ ƒ‰‡Ȁ‘‘–‘’Ǧ ƒ• ‹”‡† š̈́ͳͷǤͲͲ α̈́ ‡ˆ”‹‡”ƒ–‹‘‹–ζͳͲͲ–—ȀŠ š̈́ͳͷǤͲͲ α̈́ ‡ˆ”‹‰‡”ƒ–‹‘‹–εͳͲͲ–—ȀŠ š̈́ʹͷǤͲͲ α̈́ ‡ˆ”‹‰‡”ƒ–‹‘‹–εͷͲͲ–—ȀŠ š̈́ͷͲǤͲͲ α̈́ ‡Ǧ‹•’‡…–‹‘ˆ‡‡ȋƒŽŽȌ š̈́͹ͷǤͲͲ α̈́ ‹– ‡ƒ–‡”•ζͳͲͲ–—ȀŠ š̈́ͳͷǤͲͲ α̈́ ‹– ‡ƒ–‡”•εͳͲͲ–—ȀŠ š̈́ʹͷǤͲͲ α̈́ ‘š‡•ȋƒ”‹ƒ„Ž‡‹”‘Ž—‡ǡ’ƒ”–‘ˆƒ‹” …‘†‹–‹‘‹‰•›•–‡Ȍš̈́ͳͲǤͲͲα̈́ ƒŽŽ ‡ƒ–‡”•Ǧ ƒ• ‹”‡† š̈́ʹͷǤͲͲ α̈́ ƒ–‡” ‡ƒ–‡”Ǧ ƒ• ‹”‡† š̈́ʹͷǤͲͲ α̈́ ‡”‹– ‡‡ ̈́ ƒ„Ž‡ͶǦͺǢŽƒ‡˜‹‡™ ‡‡ ̈́ ”‘…‡••‹‰Ȁ‡…Š‘Ž‘‰› ‡‡ ̈́ʹͷǤͲͲ ‘–ƒŽ ̈́ PRESSURE PIPING SCHEMATIC      Ȃ ǡ  ˆ SCHEMATIC IS TO SCALE ˆ SCHEMATIC NOT TO SCALE Š‘™‹’‡‹œ‡ȋ•Ȍƒ†‡‰–Šȋ•Ȍˆ”‘‡–‡”–‘ƒŽŽƒ’’Ž‹ƒ…‡• NOTE:›‹–‡”‹‘”’”‡••—”‡”‡‰—Žƒ–‘”•—•–„‡‹†‹…ƒ–‡† COMMERCIAL TENANT IMPROVEMENT Ͳ͵ǤʹͲʹʹƒ‰‡ͷ‘ˆ͹ PLUMBING SYSTEM INFORMATION The following items need to be specified on the plans: ˆ ‹š–—”‡•’‡…‹ˆ‹…ƒ–‹‘•ƒ†‡“—‹’‡–™‹–ŠŽ‘…ƒ–‹‘•Ǥ ˆ‘…ƒ–‹‘ƒ†–›’‡‘ˆƒŽŽ„ƒ…ˆŽ‘™ƒ••‡„Ž‹‡•ˆ‘”‡ƒ…Šˆ‹š–—”‡Ǥ ˆƒŽ…—Žƒ–‹‘•ˆ‘” ”‡ƒ•‡ –‡”…‡’–‘”Ǥ ˆ‹’‡•‹œ‡ƒ†Ž‘…ƒ–‹‘‘ˆ•ƒ‹–ƒ”›ƒ†’‘–ƒ„Ž‡™ƒ–‡”•›•–‡•Ǥ ˆ‹•‡”†‹ƒ‰”ƒ‘ˆ™ƒ•–‡ǡ˜‡–ǡƒ†”ƒ‹™ƒ–‡”•›•–‡•ǡ‹…Ž—†‹‰•‹œ‡•Ǥ ˆ‡†‹…ƒŽ‰ƒ•’‹’‹‰”‹•‡”†‹ƒ‰”ƒǡ–›’‡‘ˆ‰ƒ•ǡ•–‘”ƒ‰‡”‘‘ƒ†•‹œ‡‘ˆ’‹’‹‰Ǥ PLUMBING PERMIT FEES (per fixture) ‘‡”…‹ƒŽ’Ž—„‹‰’‡”‹–•ƒ”‡”‡“—‹”‡†–‘•—„‹–Ž‹‡†”ƒ™‹‰•Ǥ’Žƒ”‡˜‹‡™ˆ‡‡‘ˆ͸ͷΨ’‡”ƒ„Ž‡ͶǦ͸ˆ‘” ’Ž—„‹‰’‡”‹–•™‹ŽŽ„‡ƒ••‡••‡†ƒ––‹‡‘ˆ•—„‹––ƒŽǤ …Ž—†‡•–™‘ȋʹȌ‹•’‡…–‹‘•™‹–Š’‡”‹–Ǥ Type of Fixture No. of Fixtures Cost per Fixture Subtotal ††‹–‹‘ƒŽŽƒ‡˜‹‡™ˆ‡‡• š ̈́͹ͷǤͲͲ α Ž–‡”ƒ–‹‘Ȁ”‡’ƒ‹”’‹’‹‰ š̈́ͳͷǤͲͲ α ƒ…ˆŽ‘™••‡„Ž› š̈́ʹͷǤͲͲ α ƒ•‡Ž—„‹‰ ‡‡ ̈́ʹͷǤͲͲ ̈́ʹͷǤͲͲ ƒ–ŠȀŠ‘™‡”‘„‘ š̈́ͳͷǤͲͲ α —‹Ž†‹ƒ‹ƒ•–‡ š̈́ʹͷǤͲͲ α Ž‘–Š‡•ƒ•Š‡” š̈́ͳͷǤͲͲ α ‹•Š™ƒ•Š‡” š̈́ͳͷǤͲͲ α ”‹‹ ‘—–ƒ‹ š̈́ͳͷǤͲͲ α Ž‘‘””ƒ‹• š̈́ͳͷǤͲͲ α Type of Permit: ˆ ‡™ •–ƒŽŽƒ–‹‘ˆ ††‹–‹‘ˆŽ–‡”ƒ–‹‘ˆ‡’Žƒ…‡†ˆ †—•–”‹ƒŽ Ž—„‹‰‘–”ƒ…–‘”ǣ ˆˆ‹…‡‘Ǥǣ ƒ‹Ž††”‡••ǣ ‡ŽŽ‘Ǥǣ ƒ‹Ž‹††”‡••ǣ  ‹–›ǣ –ƒ–‡ǣ  ‹’ǣ  Ƭ ‘–”ƒ…–‘”‹…‡•‡—„‡”ǣ š’‹”ƒ–‹‘ƒ–‡ǣ COMMERCIAL TENANT IMPROVEMENT Ͳ͵ǤʹͲʹʹƒ‰‡͸‘ˆ͹ PLUMBING PERMIT FEES (per fixture) ”‡ƒ•‡ –‡”…‡’–‘” š̈́͹ͷǤͲͲ α ”‡ƒ•‡”ƒ’ š̈́ʹͷǤͲͲ α ‘•‡‹„„ š̈́ͳͷǤͲͲ α …‡ƒ‡”Ȁ‡ˆ”‹‰‡”ƒ–‘” š̈́ͳͷǤͲͲ α ””‹‰ƒ–‹‘Ȃ’‡”‡–‡” š̈́ʹͷǤͲͲ α ‹–…Š‡‹Ƭ‹•’‘•ƒŽ š̈́ͳͷǤͲͲ α ƒ—†”›”ƒ› š̈́ͳͷǤͲͲ α ƒ˜ƒ–‘”› š̈́ͳͷǤͲͲ α ‡† ƒ•‹’‹ζͷ‹Ž‡–•Ȁ‘—–Ž‡–• š̈́͸ͲǤͲͲ α ‡† ƒ•‹’‹‰εͷ‹Ž‡–•Ȁ‘—–Ž‡–•ȋ’Ž—•ζͷ ‹Ž‡–•Ȁ‘—–Ž‡–•Ȍ š̈́ͷǤͲͲ α ‹•…‡ŽŽƒ‡‘—•Ȃ”‡‰—Žƒ–‡†„›’Ž—„‹‰ …‘†‡ǡ‘–‘–Š‡”™‹•‡•’‡…‹ˆ‹‡† š̈́ͳͷǤͲͲ α ”‡–”‡ƒ–‡– –‡”…‡’–‘” š̈́ͳͷǤͲͲ α ‡Ǧ‹•’‡…–‹‘ ‡‡ȋƒŽŽȌ š̈́͹ͷǤͲͲ α ‘‘ˆ”ƒ‹• š̈́ͳͷǤͲͲ α Š‘™‡”ȋ‘Ž›Ȍ š̈́ͳͷǤͲͲ α ‹ȋ„ƒ”ǡ•‡”˜‹…‡ǡ‡–…ǤȌ š̈́ͳͷǤͲͲ α ‘‹Ž‡–• š̈́ͳͷǤͲͲ α ”‹ƒŽ š̈́ͳͷǤͲͲ α ƒ…——”‡ƒ‡”• š̈́ʹͷǤͲͲ α ƒ–‡” ‡ƒ–‡” š̈́ʹͷǤͲͲ α ƒ–‡” ‡ƒ–‡”ǦƒŽ‡•• š̈́ʹͷǤͲͲ α ‡”‹– ‡‡ ƒ„Ž‡ͶǦ͸ǢŽƒ‡˜‹‡™ ‡‡ ”‘…‡••‹‰Ȁ‡…Š‘Ž‘‰› ‡‡ ̈́ʹͷǤͲͲ ‘–ƒŽ PROPOSED BUILDING USE ˆ‡™ˆ††‹–‹‘ȀŽ–‡”ƒ–‹‘ˆ‡†‹…ƒŽˆ—–‘‘–‹˜‡ƒ•‡†ˆ †—•–”‹ƒŽ ˆˆˆ‹…‡ˆ‡•–ƒ—”ƒ–ˆƒ…Š‹‡Š‘’ˆ–Š‡”ǣ̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴ CROSS CONNECTION Ž‡ƒ•‡…Š‡…ƒŽŽƒ’’Ž‹ƒ…‡•–Šƒ–ƒ”‡’”‘’‘•‡†‘”’‡”ƒ‡–Ž›…‘‡…–‡†–‘–Š‡™ƒ–‡”•—’’Ž›Ǥ ˆ …‡ƒ…Š‹‡ˆ‹ƒŽ›•‹•“—‹’Ǥ ˆ‹”™ƒ•Š‡”• ˆ‘ˆˆ‡‡”Ȁ•’”‡••‘ˆ ›†”‘–Š‡”ƒ’›“—‹’Ǥ ˆ–‡ƒ ‡‡”ƒ–‘”• ˆƒ”„‘ƒ–‡†‡˜Ǥ ˆ‡–ƒŽ“—‹’Ǥ ˆ›‡ƒ–• ˆ —‡ ‘‘†•ˆƒ„‘”ƒ–‘”›“—‹’Ǥ ˆ”‡••—”‡ƒ•Š‡”• ˆ‡‰”‡ƒ•‡”•ˆ—–‘…Žƒ˜‡Ȁ–‡”‹Ž‹œ‡”•ˆ‘‘Ž‹‰‘™‡”• ˆ ‘–—„Ȁ’ƒˆ‡…‘”ƒ–‹˜‡ ‘—–ƒ‹ˆ ‹”‡’”‹Ž‡” ˆ“—ƒ”‹—ˆ™‹‹‰‘‘Ž•ˆ’”‹Ž‡”™Ȁ…Š‡‹…ƒŽ• ˆƒ™ ””‹‰ƒ–‹‘ˆ‡ŽŽ‘’”‘’‡”–›ˆ–Š‡”ǣ̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴̴ WASTEWATER DISCHARGE ‘‡•–Š‡’Ž—„‹‰•›•–‡…—””‡–Ž›Šƒ˜‡ƒ‰”‡ƒ•‡‹–‡”…‡’–‘”ǫˆ‡•ˆ‘ˆ‘ǯ–‘™ ‘‡•–Š‡’Ž—„‹‰•›•–‡…—””‡–Ž›Šƒ˜‡ƒ‘‹ŽȀ™ƒ–‡” •‡’ƒ”ƒ–‘”ǫˆ‡•ˆ‘ˆ‘ǯ–‘™ COMMERCIAL TENANT IMPROVEMENT Ͳ͵ǤʹͲʹʹƒ‰‡͹‘ˆ͹ •™ƒ–‡”—•‡†‹–Š‡„—•‹‡••’”‘…‡••ȋ™ƒ•Š‹‰ǡ”‹•‹‰ǡ …‘‘Ž‹‰Ȍǫˆ‡•ˆ‘ˆ‘ǯ–‘™ ‘‡•›‘—”„—•‹‡••”‡“—‹”‡ƒ’‡”‹–ǫˆ‡•ˆ‘ˆ‘ǯ–‘™ Š‡”‡„›…‡”–‹ˆ›–Šƒ––Š‡ƒ„‘˜‡‹ˆ‘”ƒ–‹‘‹•…‘””‡…–ƒ†–Šƒ––Š‡…‘•–”—…–‹‘‘ǡƒ†–Š‡‘……—’ƒ…›ƒ†–Š‡—•‡‘ˆ –Š‡ƒ„‘˜‡Ǧ†‡•…”‹„‡†’”‘’‡”–›™‹ŽŽ„‡‹ƒ……‘”†ƒ…‡™‹–Š–Š‡Žƒ™•ǡ”—Ž‡•ƒ†”‡‰—Žƒ–‹‘‘ˆ–Š‡–ƒ–‡‘ˆƒ•Š‹‰–‘ ‹ƒ–—”‡ ”‹–ƒ‡ ƒ–‡  +DUROG&KULVWHQVHQ SPECIAL INSPECTION AND TESTING AGREEMENT Community and Economic Development City of Arlington • 18204 59th Ave NE • Arlington, WA 98223 • Phone (360) 403-3551 Page 1 of 4 - REV03.2022 In accordance with International Building Code Chapter 17, where application is made for construction as described in this section, the Owner or the License Design Professional responsible for, and acting as the owner’s agent shall employ one or more Special Inspectors to provide inspections during construction. Before a permit can be issued: The owner, Architect or Engineer of record acting as the owner's agent, shall complete this agreement, including the required acknowledgements, and attach structural tests and inspections schedules. A pre-construction conference with the parties involved may be required to review the special inspection requirements and procedures. Property Address: Lot #: Parcel ID No.: Subdivision: Project Description: Primary Contact: Owner Architect Engineer Contractor Owner Name: Office No.: Email Address: Cell No.: Mailing Address: City: State: Zip: Architect Name: Office No.: Email Address: Cell No.: Mailing Address: City: State: Zip: Professional License Number: Expiration Date: Engineer Name: Office No.: Email Address: Cell No.: Mailing Address: City: State: Zip: Professional License Number: Expiration Date: Contractor Name: Office No.: Email Address: Cell No.: Mailing Address: City: State: Zip: L&I Contractor License Number: Expiration Date: Page 2 of 4 - REV03.2022 SPECIAL INSPECTION AND TESTING SHALL MEET THE MINIMUM REQUIREMENTS OF 2018 IBC. THE FOLLOWING CONDITIONS ARE ALSO APPLICABLE. 1. Duties and Responsibilities of Special Inspector a. Observe Work: The Special Inspector shall observe the work for conformance with City of Arlington approved (stamped) design drawings and specifications and applicable workmanship provisions of the IBC The Architect/ Engineer-reviewed shop drawings and/ or project drawings may be used only as an aid to inspection. b. Report Non-Conforming Items: The Special Inspector shall bring non-conforming items to the attention of the Contractor and note all such items in the daily report. If any item is not resolved in a timely manner or is about to be incorporated in the work, the Special Inspector shall immediately notify the City of Arlington by telephone or in person, and notify the project Architect or Engineer. c. Furnish Daily Reports: Each Special Inspector shall complete and sign an inspection report for each day's inspections to remain at the job site with the contractor for review by the City of Arlington. d. Furnish Weekly Reports: The Special Inspector or agency shall furnish weekly reports of tests and inspections directly to the City of Arlington, project Architect/ Engineer, and others as designated. These reports must include the following: i. Description of daily inspections and test made, with applicable locations. ii. Listing of all non-conforming items. iii. Report on how non-conforming items were resolved or unresolved, as applicable. iv. Itemize all changes authorized by the Architect/ Engineer of Record and City of Arlington if not included in non-conformance items. e. Furnish Final Report: The Special Inspector or inspection agency shall submit a final signed report to the City of Arlington stating that all items requiring special inspection and testing were fulfilled and reported, and to the best of his/ her knowledge, in conformance with the approved design drawings, specifications, approved change orders and the applicable workmanship provisions of the IBC. Items not in conformance, unresolved items or any discrepancies in inspection coverage (i.e., missed inspections, periodic inspections when inspection was required, etc.) shall be specifically itemized in this report. 2. Contractor Responsibilities a. Notify the Special Inspector: The Contractor is responsible for notifying the Special Inspector or agency regarding individual inspection items on the summary schedule and as noted on the City of Arlington approved plan as specified by the Architect and or Engineer of record. b. Provide Access to Approved Plans: The Contractor is responsible for providing the Special Inspector access to approved plans at the job site. c. Retain Special Inspection Records: The Contractor is also responsible for retaining at the job site all Special Inspection records submitted by the Special Inspector and providing these records for review by City of Arlington, upon request. 3. City of Arlington a. Approve Special Inspector: The City of Arlington shall approve all Special Inspectors prior to performing any inspection. b. Monitor Special Inspection: Work requiring special inspection and the performance of Special Inspectors shall be monitored by the City of Arlington. His/ Her approval must be obtained prior to placement of concrete or similar activities in addition to that of the Special Inspector. Page 3 of 4 - REV03.2022 4. Owner Responsibilities a. Funding: The project owner or the Architect or Engineer of record acting as the owner's agent shall fund the Special Inspection Services. 5. Architect or Engineer of Record Responsibilities a. Drawings: The Architect or Engineer of record shall include special inspection requirements on the design drawings and specifications. b. Schedule Inspections: Provide a summary schedule of required inspections which would outline frequency of inspections for items which may require multiple inspections which may include but are not limited to concrete and grout testing, compaction, testing of backfill and or road beds as recommended by the geo-tech engineer, and structural welding as work progresses. 6. Indicate items requiring special inspection, structural testing, or structural observations by checking the appropriate box. ☐ STRUCTURAL STEEL ………………………………………………………………. (IBC 1705.2.1 & 1705.12.1) ☐ STEEL CONSTRUCTION OTHER THAN STRUCTURAL STEEL ……. (IBC 1705.2.2) ☐ CONCRETE CONSTRUCTION ……………………………………………………. (IBC 1705.3) ☐ MASONRY CONSTRUCTION ……………………………………………………... (IBC 1705.4) ☐ WOOD CONSTRUCTION …………………………………………………………… (IBC 1705.5, 1705.11.1 & 1705.12.2) ☐ SOILS CONSTRUCTION …………………………………………………………….. (IBC 1705.6) ☐ DRIVEN DEEP FOUNDATIONS …………………………………………………. (IBC 1705.7) ☐ CAST-IN-PLACE DEEP FOUNDATIONS ……………………………………… (IBC 1705.8) ☐ HELICAL PILE FOUNDATIONS …………………………………………………. (IBC 1705.9) ☐ SPRAYED FIRE-RESISTANT MATERIALS ………………………………….. (IBC 1705.14) ☐ MASTIC AND INTUMESCENT FIRE-RESISTANT COATINGS ……….. (IBC 1705.15) ☐ EXTERIOR INSULATION AND FINISH SYSTEMS (EIFS) ……………… (IBC 1705.16) ☐ FIRE-RESISTANT PENETRATIONS AND JOINTS ……………………….. (IBC 1705.17) Only required for high-rise buildings or those assigned to Risk Category III or IV per IBC Table 1604.5. ☐ SMOKE CONTROL ……………………………………………………………………. (IBC 1705.18) ☐ ARCHITECTURAL COMPONENTS …………………………………………….. (IBC 1705.12.5) Only required for buildings located within Seismic Design Category D, E, or F ☐ PLUMBING, MECHANICAL & ELECTRICAL COMPONENTS …………. (IBC 1705.12.6) Only required for buildings located within Seismic Design Category C, D, E, or F ☐ SEISMICALLY ISOLATED SYSTEMS …………………………………………... (IBC 1705.12.8) Material alternatives or unusual design applications ☐ SPECIAL CASES ………………………………………………………………………... (IBC 1705.1.1) ☐ MISCELLANEOUS AREA These inspections may be recommended by the Architect/Engineer and are to be approved by the Building department. Page 4 of 4 - REV03.2022 Acknowledgements I HAVE READ AND AGREE TO COMPLY WITH THE TERMS AND CONDITIONS OF THIS AGREEMENT. (Attach more sheets for signatures if necessary) Owner Name: Date: Signature: ☐ Submit written statement of responsibility in accordance with IBC Section 1704.4. Special Inspector Name: Date: Signature: ☐ Submit WABO certification for special inspection agency and inspectors, (or) ☐ Submit Special Inspection agency documentation for Building Official approval. Names of Special Inspectors Scope of Work. Submit copies of inspector certifications provided for each discipline. Architect/Engineer of Record Date: Signature: ☐ Statement of Special Inspections completed and submitted in accordance with IBC Section 1704.3. ☐ Structural Observations required in accordance with IBC Section 1704.5. ● ●●● ● ● ● ● ● ● ● ● ● ●● ● ● ● ●19020 33rd Ave W #530 Lynnwood, WA 98036 ●206.525.7560 fax 206.522.6698 www.engineersnw.com September 26, 2024 LMA 140 Lakeside Avenue, Suite 310 Seattle, WA 98122 ATTN: Harold Christensen RE:Arlington Airport Industrial Park Bldg B –NCS T.I.-Leveler Pit Additions Structural review and drawings ENW Project No. 22022010 Harold, Please find the attached set of structural permit drawings for the above-mentioned project. Note, there are no structural calculations accompanying these drawings as there is no structural change to the building. The leveler pits will be added at existing exterior shear wall openings only. There are no new wall openings required for this project. Therefore, there is no change in impact to the existing building’s lateral system. The existing building is structurally adequate for this project. Please included this letter as part of your permit submittal to the city. Should you require any additional information regarding this project, please contact us call. Sincerely, ENGINEERS NORTHWEST, INC., P.S. Joanne Bayuga, P.E. Senior Project Engineer JB:ag