HomeMy WebLinkAbout1105 E 5TH ST_3344_2026 APPLICATION LJNSTRUCTION INFORMi,.. ION
FOR: Certificate of Zoning Compliance ❑ To CITY of ARLINGTON CLASS of WORK (check) NEW ❑ , ALTERATION X❑ , ADDITION ❑ , DEMOLISH ❑.
Building Department
Building Permit ® Describe Alteration Re-roof (20 sq)
Certificate of Occupancy ❑ Date 3/11/86
NOTICE: No permit for erection, alteration, moving, repair or occupancy of any building 1 ,237 .00
shall be issued until an application has been made and approved for a certifi- Valuation based on total floor area $ N O T I C E
cate of zoning compliance. Where work is started
Plan checking fee $ before permit is obtained
Owner Charles Donnelson Address 1105 5th St . E. Permit fee $ C � '00 the permit fee shall
Arlington, Washington be doubled.
Wash. State Building Code Fee 1.60
Permittee Address Wash. State Energy Studies Surcharge3
Architect _ _ Address
�O I
SPECIFICATIONS
Engineer _ Address �.�
Everett Bldrs . Inc. 5606 Evergreen Way FOU / Exterior Piers COVERING
Contractor Address
- 4 %j rr-
Everett , Washington Material Exterior walls
CITY ar-
q3 Zd IYGr Interior walls
LEGAL DESCRIPTION OF PROPERTY: Lot No. .Block No. Width at top ON
Subdivision or Unplatted description
Victor Heights 1 BLK 000 D-00-Lot 14 Width at bottom Roof or reroofing
Depth in ground
ZONING INFORMATION FRAME Size Spacing Span FLUES
TYPE OF OCCUPANCY of present or TYPE of CONSTRUCTION of present or R.W. Plate(sill) Fireplace
proposed main building (circle) proposed main building (circle) Girders Floor furnace
A B C D E F G H I J 1 II III III 1 hr. III HT Joist, 1st floor Kitchen
DIVISION 1 2 3 4 IV IV 1 hr. V V 1 hr. Joist,2nd floor Water heater
Joist,ceiling Furnace
Use Zone Fire Zone Area of Lot
Size of building or addition No.of stories Exterior studs Gas Oil
Total height Basement floor area 1st Floor area
Interior studs
Additional floors and areas
No. of rooms No.of families Roof rafters
No.of buildings now on lot. Use of buildings now on lot
Bearing walls
Percentage of lot covered by main building Additional Permits are required for:
Percentage of lot covered by accessory buildings (check) IMPORTANT
Kind of livestock
❑ Plumbing, ❑ Signs, ❑ Moving, Written authorization of owner must
CHANGE OF OCCUPANCY from to ❑ Sewer hookup, ❑ Water hookup, be presented when applicant is occupant
If a commercial building,list each use and its area in square feet: ❑ Gas appliance and Gas piping. or lessor. I am the legal owner of the
I hereby acknowledge that I have read this application and property described in this application.
state that the above is correct and agree to comply with all
city ordinances and/State La s relating zoning and building
Owner
DRAW on the reverse side of this application, to scale, a PLOT PLAN.
APPLICANT
PLOT PLAN FOR DEPARTMEN.AL USE `
Draw below,to scale,a plot plan showing: FOR DEPARTMENTAL USE Application for Certificate of Zoning Compliance El
Checked Initials
1. Dimension and shape of the lot. 1
2. Front street name. 2. Building Permiv `Certificate of Occupancy Elchecked and approved.
3. Side street name if corner lot. 3. dinA
4. Sizes and location on the lot of buildings already existing. 4. _ 3 �3��
5. Location and dimensions of proposed building or alterations. 5. Building Ins pector /,— '�_ Date
6. Front yard,side yard,rear yard setbacks. 6. 3 go
7. Locate and describe any fences,walls,hedges,signs, 7. Issued Building Permit No. e� Date
front yard trees and shrubs,green belt.
8. Location and size of required off-street parking and loading 8.
INSPECTION RECORD
Inspection Date Signature
Set Back
Excavation
Concrete
Reinforced Steel
Grout Blocks
Bond Beam
Frame
`� Roofing
Room Ventilation
Kitchen Vent
Bathroom Vent
Foundation Vent
Access Hole
Garage Fireproofing
Fireplace
Spark Arrester
Water Closet
Water Heater
Sewage Disposal
Lathing
Plastering
Correction Order Left
Stop Work Order Issued
Stop Work Order Released
Give brief report of special or unusual conditions
Job completed Date
Building Inspector
Certificate of Zoning Compliance No. Issued
Date
Certificate of Occupancy No. Issued
Date
MOORE BUSINESS FORMS INC LA
APPLICATION %-ONSTRUCTION INFORM. ilON
FOR: Certificate of Zoning Compliance 1-1 To CITY of ARLINGTON CLASS of WORK (check) NEW ❑ , ALTERATION ❑ , ADDITION , DEMOLISH ❑.
Building Department 4 a Oof.
Building Permit � Describe Alteration �G
Certificate of Occupancy ❑ Date /0 - / —V'/
NOTICE: No permit for erection, alteration, moving, repair or occupancy of any building
shall be issued until an application has been made and approved for a certifi- Valuation based 4onal ea $_5P040 N O T I C E
cate of zoning compliance.
Where work is started
To 4A. �• + Plan checki fee �— before permit is obtained
Owner----.X � D/f//1'G�S��'✓ Address_��� S� G J T� Permit � $ s�� S the permit fee shall
be doubled.
Permittee Address
Architect Address O
SPECIFICATIONS
Engineer Address
FOUNDATION I Exterior Piers COVERING
Contractor _Address Material Exterior walls
LEGAL DESCRIPTION OF PROPERTY: Lot No. Block No.000,0-04 Width at top Interior walls
Subdivision or Unplatted description C-0` v �41'1 4,7S r Width at bottom Roof or reroofing
Depth in ground
ZONING INFORMATION FRAME Size Spacing Span FLUES
TYPE OF OCCUPANCY of present or TYPE of CONSTRUCTION of present or R.W. Plate(sill) Fireplace
proposed main building (circle) proposed main building (circle) Girders Floor furnace
A B C D E F G H I J 1 II III III 1 hr. III HT Joist, 1st floor Kitchen
DIVISION 1 2 3 4 IV IV 1 hr. V V 1 hr. Joist,2nd floor Water heater
Joist,ceiling Furnace
Use Zone _Fire Zone Area of Lot
Size of building or addition No.of stories Exterior studs Gas Oil
Total height _ Basement floor area 1 st Floor area
Interior studs
Additional floors and areas _
No.of rooms No.of families _ Roof rafters
No.of buildings now on lot Use of buildings now on lot_
Bearing walls
Percentage of lot covered by main building - Additional Permits are required for:
Percentage of lot covered by accessory buildings (check) IMPORTANT
Kind of livestock ❑ Plumbing
, El Signs, ❑ Moving, Written authorization of owner must
CHANGE OF OCCUPANCY from to ❑ Sewer hookup, ❑ Water hookup, be presented when applicant is occupant
If a commercial building,list each use and its area in square feet: ❑ Gas appliance and Gas piping. or lessor. I am the legal owner of the
I hereby acknowledge that I have read this application and property described in this application.
state that the above is correct and agree to comply with all
city ordinances ,,a///nd Sta Laws regulating z ing and building
Owner
DRAW on the reverse side of this application,to scale, a PLOT PLAN. APPLICANT )t ®"
PLOT PLAN
FOR DEPARTMEfo.AL USE
Draw below to scale an sow
p p g� Checked Initials pp p
a lot Ihin FOR DEPARTMENTAL USE Application for Certificate of ZoningCompliance
❑
_
1. Dimension and shape of the lot. 1,
2. Front street name. 2. Building Permit Certificate of Occupancy ❑ checked and approved.
3. Side street name if corner lot. 3. , ,
4. Sizes and location on the lot of buildings already existing. 4. /
5. Location and dimensions of proposed building or alterations. 5. Building Inspector9 Date
6. Front yard,side yard,rear yard setbacks. 6.
7. Locate and describe any fences,walls,hedges,signs, 7. Issued Building Permit No. Date �G1 51—lkl
front yard trees and shrubs,green belt.
8. Location and size of required off-street parking and loading. 8.
INSPECTION RECORD
Inspection Date Signature
Set Back
Excavation
Concrete
Reinforced Steel
Grout Blocks
Bond Beam
Frame
Roofing
Room Ventilation
Kitchen Vent
Bathroom Vent
Foundation Vent
Access Hole
Garage Fireproofing
Fireplace
Spark Arrester
Water Closet
Water Heater
Sewage Disposal
Lathing
Plastering
Correction Order Left
Stop Work Order Issued
Stop Work Order Released
Give brief report of special or unusual conditions.
Job completed Dat���
Building Inspector
Certificate of Zoning Compliance No. Issued
Date
Certificate of Occupancy No. Issued
Date
MOORE BUSINESS FORMS INC.LA
City of Arlington
Code Enforcement Office
Third&Olympic
Arlington,Wa.
435-5255
Date
Occupancy rr /t c
Address //� 5 y e;fy
Owner or Manager
Person notified
Under authority of sec. UFC
a survey of the premises was made by the undersigned and discrepancies in
fire standards were noted as follows:
-7 �a
Ise i
A- IZ6
Xj
�-Gfif.Llr.^ t.t-�l�ii1" -1 � '�'/ ��-(' �lf'--•/ �.�L`l.�Ii^4i
�[A",•� '2, �/-Yr./..•�!' �--e.C�'s_.t� , y t -�'.:.rl d--1rt� i��� !/-I-�
YOU ARE HEREBY REQUIRED TO CORRECT THE ABOVE item(s)WITHIN_
AT WHICH TIME A REINSPECTION WILL BE MADE.
SEC. U.F.C.
R. D. Mulligan j
-Code Enforcement
Officer Inspector
"Practice Fire Prevention"