HomeMy WebLinkAbout107 S STILLAGUAMISH AVE_1441_2026 Permit No.
City of Arlington
C, NOTICE and Inspection Report
Date Called i I� Address D
Ti � �me Called.d Contractor/Owner !41
By Requested by
—Z- J I h.��
TYPE OF •
❑ Setback ❑ Reroof ❑ Insulation
❑ Plumb GW ❑ Roof Diaphragm ❑ Gas Piping
❑ Footing ❑ Framing Woodstove
❑ Foundation ❑ Drywall Nailing ❑ inal
❑ Concrete Slab ❑ Rough-in Plumbing ❑ Reinspection
❑ Shear Wall ❑ Furnace ❑ Other
APPROVAL ❑ CORRECTION REQUIRED
❑ Corrections listed below MUST BE MADE before work can be approved.
> Work listed below has been inspected and approved.
❑ CALL 435-0724 FOR REINSPECTION-24 hour notice required.
i
Inspector Date ���
CITY OF ARLINGTON
CONSTRUCTION
PERMIT
❑ COMBINATION ❑ BUILDING ❑k MECHANICAL ❑ PLUMBING ❑ SIGN N® 1441
PERMIT NO. -
OWNER MAIL ADDRESS CITY ZIP PHONE
Don & Shirley Christensen 10,7 S' Stillaguamish Arlington 98223 435-4001
ARNtTrCT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE
GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LIC NSE#
Home Town Heating 609 State Ave. Marysville 98270 659-6901 HOMETH075Q2
MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE
PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N
CLASS OF WORK
❑NLW ❑ADDITION ALTERATION ❑ REPAIR ❑DEMOLITION BUILDING RELOCATION
VALUATION OF WORK
f 180.0
DESCRIBE WORK
Install fre-e standing gas- stove & piping
PROPOSED USE OF BUILDING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA-
TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI-
LLGAL DES(RIPI)ON OF PROPLRTY(SHOWN BELOW OR ATTACH FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK
LOr BLOCK - OF WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT. THE
GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO
VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR
TAX ID NUMBER LOCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF
5412!^0,00-0O3--0QO8 CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE.
TUREOFCONi RORAUTHORIZEDAGENT DATE
IOB ADDRESS
107 S Stilla uamish
(OFFICE USE ONLY)
MECHANICAL
PLUMBING
NO. TYPE OF FIXTURE FEE NO, TYPE OF EQUIPMENT FEE
WATER CLOSET (TOILEI) AIR COND UNITS -H P. EA _
BAIFIIUB REFRIGERATION UNITS - H P. EA.
LAVATORY (WASH BASIN) BOILERS - H.P EA _
SHOWLR GAS FIRED A.C. UNITS-TONNAGE EA
KI fCHLN SINK & DISP FORCED AIR SYSTEMS - B T U MEA
DISHWASHER WALL HEATERS- B.T U M
LAUNDRY 1 RAY UNIT HEATERS- B.T.U. M
CLOIHLS WASHER EVAPORAI IVE COOLERS
WAIERHEATLR CLOTHES DRYERS
URINAL VENTILATICN FAN
DRINKING FOUN 1 AIN RANGE HOOD COMMERCIAL
FLOOR DRAIN AIR HANDLING UNIT- CPM
VACUUM BREAKERS 1 STOVE 6
50
ROOF DRAINS - RAINLEADERS METAL FIREPLACE &CHIMNEY
SINK (SERVICE - BAR, ETC-) WATER HEATER
GAS PIPING
SUB TOTAL S SUBTOTAL f 9
PERMIT ; PERMIT f
TOTAL FEE f TOTAL FEE f 2A
SIDL YARD SL IBACK STRLLT SETBACK REAR YARD SETBACK DATE RECEIVED PLAN CHECK FEE
FEE RECEIPT NO
�.! /ONE LOT AREA VACANT SITE
❑YES ❑NO FEES VALUATION FEE
TYPE OF CONST OCCUPANCY GROUP NO.OF DWELLING UNITS PLAN CHECKING VG
BU'LDING $
SIZE OF BLDG NO.OF STORIES MAX,OCC LOAD
PLUMBING
F IRE SPRINKLERS REQUIRED
❑YES ❑NO MECHANICAL 24 50
STATE BLDG.CODE
COMMENTS ENERGY CODE SURCHARGE
U,BC
PENALTY SEC 303(a)
WATEPUSEWER FEES
PAID TOTAL 24 50
w - - PERMIT VALIDATION
I - '�`9 ' WHEN PR Y IV, IDATED (IN THIS SPACE) THIS IS YOU�PET RECEIPT
PAID CR
$U 6 EC AL ATE
cc: ASSESSOR,APPLICANT,TREASURER, BLDG. DEPT- RECORDS COPY
CITY OF ARLINGTON
CONSTRUCTION
PERMIT
❑ COMBINATION ❑ BUILDING x MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO.
MAIL ADDRESS CITY ZIP BONE
�
, t�� ASE'S �(�)� 5• �L!ax �,�� CA s`.�` �� S
ARCHITECT OR DESIGNER MAIL ADDRESS CI Y ` ZIP PHONE
GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LIC NSE N
MECHANICAL CONTRACTOR MAIL ADDRESS• CITY ` ZIP PRUNE_ LICENSE if
PLUMBING CONTRACTOR MAIL ADDRESS C Y ZIP PHONE LICENSE/
3 CLASS OF WORK
CC❑NLW ❑AUDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION
❑BUILDING RELOCATION
IXVALUATION OF WORK
ov
z s G
W DESC IBE WORK \ `
m PROPOSE D USE OF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA-
TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI-
uw
Z LLGAL DES(RIP)ION OT PROPLRTY (SHOWN BELOW OR AT IACH FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK
WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE
Lur—BLOCK OF GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO
w /�� _ VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR
I- 'T LOCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF
a TAX ID NUMBER FROM PROPERTY TAX STATEMENT CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OFISS�NCE,�
SIGN OF CONTRACTOR RITHORIZEO AGENT DATE
0 I08 ADDR1 S, 1
X
v
— 1 (OFFICtf USE ONLY) ECHANICAL
PLUMBING FEE z's FIXTURES
TYPE OF FIXTURE FEE i s FIXTURES NO. TYPE OF EQUIPMENT
NO. ti .list•'
ATER CLOSET(TOILET) f7.00 lR COND.UNITS—H.P. FA.
Fl RIGERATION UNITS—H P.EA 7 ti .list••
ATHTUB $7.00
,AVAT'ORY(WASII BASIN) $7.00
OILERS—H.P.F.A. tip.list"
HOWER $7.00 AS FIRED A.C.UNITS—TONNAGE EA. ti •list••
TCHEN SINK R DISPOSAL $7.00 ORCED AIR SYSTEMS—B.T.U. MIS $9.00
ALL HEATERS—B.T.U. M $9.00
ISHWASHER 7'� $9.00
UNDRY TRAY f7.00 NIT HEATERS—B.T.U. M
LOITEES WASHER $7.00 VAPORATIVE COOLERS
ATE- HEATER $7.00
LOTIIES DRYERS $6S0
f700 FNTII/�TtON FAN f4SO
.
RINAL f6S0
RINKING FOUNTAIN $7.00 ANGE HOOD COMMERCIAL
00 IR HANDLING UNIT— CPM
AI
LOOR DRN f7 $6.50 5D
00 OVE
ACUUM BREAKERS f7 f6S0
t?TAL FIREPLACEdt CtIIMNEY
OOF DRAINS—RAINLEADERS t7•00
$7.00 EATER f6S0
INK(SERVICE—BAR.E1C.
ATER H
AS PIPING *(up to S=f3.00,sddnl.=_5.75
•Equipment list must be provided
SUBTOTAL
SUB TOTAL PERMIT
PTRMII
TOTAL FEE
TOTAL FEE _ PLAN CHECK FEE
SIDL YARD SE I BACK STRLLT SL I BACK REAR YARD SETBACK PLAN CHECK NUMBER FEE RECEIPT NO.
USE LONE LOI AREA VACANT SITE FEES VALUATION FEE
❑YES ❑NO
TYPE OF CONS1 OCCUPANCY GROUP NO.OF DWELLING UNITS
PLAN CHECKING NG
BUTDING f
SILL Or BLDG. NO.Of STORIES MAX.OCC.LOAD
PLUMBING
F IRE SPRINKLERS REQUIRED Y
YES ❑NO MECHANICAL
STATE BLDG.CODE
COMMENTS ENERGY CODE SURCHARGE
U.B.C.
p i, PENALTY SEC.303(,)
E
WATER/SEWER FEES
J�
PR ? 6 19994 TOTAL
►v PERMIT VALIDATION
'I I Y `l•- i� I1�+;;TUI` WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS IS YOUR PERMIT✓y RECEIPT
PAID CRR BY
�— DATE
BUILDING OFFICIAL
cc:ASSESSOR,APPLICANT,TREASURER,BLDG DEPT RECORDS COPY