HomeMy WebLinkAbout19919 54TH DR NE_1616_2026 City of Arl. 2gton
NOTICE aDA Inspection Report
Permit No. Legal 'y)
Date Called I /�/�`% Address MIS
r
Time Called '/,5 Contractor/Owner �
By ��"� Requested _
TYPE OF INSPECTION REQUESTED
❑ Setback ❑ Roof Diaphragm ❑ Insulation
❑ Plumb GW ❑ Framing �Piping
❑ Footing ❑ Drywall Nailing ❑ Final
❑ Foundation ❑ Roughin Plumbing ❑ Reinspection
❑ Shear Wall ❑ Mechanical ❑ Other
APPROVAL ❑ CORRECTION REQUIRED
ELIJ.Porrecdons listed below MUST BE MADE before work can be approved.
Work listed below has been inspected and approved.
❑ CAL -OM4 FOR REI PECTION—24 hour notice required.
Inspector Date
CITY OF ARLINGTON
CONSTRUCTION
PERMIT `
r ❑ COMBINATION ❑ BUILDING -b� MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO.
j OWNER MAIL ADDRESS r_ CITY ZIP PHONE
1/2-
ARCHITECT OR DESIGNER MAIL A`D�RES CITY 1 HONE
► Tlou7 a 6G
EN4ALCON�IRACT R MAIL AD ESS ITV ZIP PHONE ���LICENS���
/ MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE/
PLUMBING CONTRACTOR MAIL ADDRESS
CITY Zip PHONE LICENSE I
3 CLASS OF WORK
0❑NLW ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLI LION ❑BUILDING RELOCATION
CC
-im !VALUATION OF WORK
f _GY-7
yi ESC IBE WORK
i_L-. G s 5 n'U aU S -
m PRUPOSt U USE Of BUILDING 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA-
w TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI-
Z LL4AL DES('RIPI TUN OI PROPERTY(SHOWN BELOW OR ATTACH FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK
J
� Lust 3 BL(X:k � OF Q � C � WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE
e GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO
W VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR
LOCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF
J TAX ID NUMBER p FROM PROPERTY TAXI STATEMENT CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE.
3 0/' 1 LtJ /� �•( J 1 o / SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE
0
U JOB ADURLSS 'n �. X I
col
(OFFICE USE ONLY) ECHANICAL
PLUMBING FEE :'a FIXTURES
TYPE OF FIXTURE FEE i s FIXTURES NO. TYPE OF EQUIPMENT
NO. ti .lilt'•
ATER CLOSET ILI3T $7900
IIt COND.UN17S—H P. EA.
A7TITUB 57.00
FfRIGERATION UNITS—H.P.FA ni •list"
VATORY ASiI BASIN) 7.00
OILERS—H F..P. A. ut 'list"
$
t WF1t 7.00 AS PBLBD A.C.UNITS-TGNNAGSEA. vi .list"
TC SINK R DISPOSAL $7.00 ji
IR SYSTEMS—B.T.U. MEA $9.00
$7.00 TERS-B.T.U. M $9.00
ISt{W ER 39.00
UNDRY Y $7.00 TERS-B.T.U. M
LOTHES WAS1 R $7.00 TIVECOOLERS
ATER HEATFIL $7.00
DRYERS $630
f7.00 RATION PAN f4SO
RINAL $6S0
KINKING FOUNTAIN $7.00
OD COMMERCIAL
LOOR DRAIN $7.00 LING UNIT— CPM
f7 00 f630
UUM BREAKERS $630
i7 00 REPLACER CHIMNEY
GOP DRAINS—RAINLEADERS
$7.00 R IIEATER f6S0
INK(SERVICE—BAR.ETC.
AS PIPING *(UE to 5=$3.00.addnl.=f.TS
..Equipment list must be provided
SUB TOTAL
SUB TOTAL PERMIT
PERMIT
TOTAL FEB
TOTAL FBE _ PLAN CHECK FEE
SIUL YARD SL IBACK STRLLI SL IBACK REAR YARD SETBA K PLAN CHECK NUMBER FEE RECEIPT NO
USF/ONt LOT AREA VACANT SITE VALUATION FEE
❑YES ❑
NO FEES
tVPL OF CONS OCCUPANCY GROUP NO.OF DWELLING UNITS
PLAN CHECKING NG
BUTDING f
SILL OI BLM. NO.Of STORILS MAX.00C.LOAD
PLUMBING
F IRE SPRINKLERS REQUIRED
❑YES ❑NO MECHANICAL
CPENALTY
DE
COMMENTS URCHARGE
U.B.C.
SEC.303(a)
EES
TOTAL
FPERMITVALIDATION
LIDATED (IN THIS SPACE)THIS IS YOUR PERMIT&RECEIPT
_CR# -- BY
DATE
BUILOING OFFICIAL
Cc:ASSESSOR,APPLICANT,TREASURER,BLDG DEPT RECORDS COPY
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i CITY OF ARLINGTON
CONSTRUCTION
PERMIT M 1616
COMBINATION ❑ BUILDING ® MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO_.
Ov;NLR MAIL ADDRESS CITY ZIP PHONE
David L. Whitmore 19919 54th Dr NE Arlington 98223 435-7042
ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE
GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N
Dav0 s Installations 1701 Broadway Everett WA 259-4619 DAVESI*096PS
MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE
PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE_
CLASS OF WORK
❑NLW [jJADDITION ❑ALTERATION ❑REPAIR ❑DEMOLI TION ❑BUILDING RELOCATION
VALUATION OF WORK
f 4477. 85
DESCRIBE WORK
Install Gas Stove inserts (2) in fireplaces
PROPOSED USE OF BUILDING
SFR, 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(RIPTIUN OF PROPLRTY(SHOWN BELOW OR ATTACH FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK
LOI 3 BLOCK OF ProgRect Point 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 OFTHE PERFORM.ANCEOF
CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE.
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE f
108 ADURI SS Z ` 12-60
19919 54th Dr NE X , /
(OFFICE USE ONLY)
MECHANICAL
PLUMBING
NO. TYPE OF FIXTURE FEE NO. TYPE OF EQUIPMENT FEE
WATER CLOSEI (TOILET) AIR COND UNITS - H P. EA.
BAIII]UB REFRIGERATION UNITS - H P EA
LAVATORY (WASH BASIN) BOILERS - H P EA
SHOWER GAS FIRED A C. UNITS - TONNAGE EA
KI ICHLN SINK & DISP. FORCED AIR SYSTEMS- B T U MEA
DISHWASHER WALL HEATERS- B,T.0 M
LAUNDRY TRAY UNI I HEATERS- B.T.U. M
CLOTHES WASHER EVAPORAIIVECOOLERS
WA I LR HEATER CLOTHES DR YERS
URINAL VENTILATICN FAN
DRINKING FOUN I AIN RANGE FIOOD COMMERCIAL
FLUOR DRAIN AIR HANDLING UNIT- CPM
VACUUM BREAKERS STOVE
ROOF DRAINS - RAINLEADERS METAL FIREPLACE &CHIMNEY
SINK (SERVICE - BAR,ETC.) WATER HEATER
GAS PIPING
SUBTOTAL f SUBTOTAL f
PERMIT S PERMIT f
TOTAL FEE f TOTAL FEE f 'All UO
SIDE YARD SE IBACK STRELI SETBACK REAR YARD SETBACK PLAN CHECK FEE
DATE RECEIVED FEE RECEIPT NO
USE /UNF LOT AREA VACANT SITE
FEES VALUATION FEE
❑YES ❑NO
TYPE OF CONS] OCCUPANCY GROUP NO.OF DWELLING UNITS PLAN CHECKING NG
BU'LDING f
SIZE OF BLDG. NO.OF STORILS MAX.000.LOAD
PLUMBING
F IRE SPRINKLERS REQUIRED
❑YES ❑NO MECHANICAL 31, 00
STATE BLDG,CODE
COMMENTS ENERGY CODE SURCHARGE
PENALTY U.B.C.
SEC.303(a)
Mechanical Only AL1 WATER/SEWERFEES
L1 Q(� TOTAL 3 1 0 0
'J 1994 PERMIT V IDATION
WHEN PR P Y VALIDATED IN THIS SPACE) THIS IS YOUR PERMIT&R EIP
PAID_ CR# - W BY
BUR VI? OFfICIAI ATE '
cc:ASSESSOR,APPLICANT,TREASURER, BLDG DEPT RE ORDS COPY