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Home My WebLink About19919 53RD AVE NE_3641_2026 City i ARLINGTON PERMIT APPLICATION 230 N. OLYMPIC AVE., ARLINGTON, WA 98223 (206) 435-5785 COMMERCIAL, RESIDENTIAL, MECHANICAL, PLUMBING, GRADING a Tax Account Number J Job Site Address Al 1 11 — 5 3-0-� City Applicant Name C_AA;( L"kdA Phone y357—%3�— Mailing Address 1 � �� — City !/ ,v Zip F Contractor Name CO Z'r j j G License # 0—og-t4 — Address 2.0Z.2-1 ke A— City � Zip :'1?2-2-3 Phone q3 �= Architect/Engineer License # Address City Zip Phone TYPE OF PROJECT G AS 72 Sewage Disposal Right-of-Way Width Culvert Permit No. LOCATIONAL INFORMATION: SEC TWP RGE 16th Plat Name/Short Plat No./Segregation No. Lot/Parcel # Block # Lot Size Is the average slope of the property in excess of 25%? Yes No Has construction started? Yes No This structure will be used for the following purpose Other buildings on this property OWNER/AGENT SIGNATURE DATE NOTICE: Front Yard Setbacks. Curbs, Sidewalk Edge, Edge of Street pavement is not necessarily your front property line. In the case where your setback will be measured from the front property line, be certain that you are measuring from the actual front property line and that your plot plan depicts this. In the event your setback will be measured from a private access easement,the edge of the improved road is not necessarily your front property line. Be certain that you are measuring from the edge of the actual easement and that your plot plan depicts this. ACKNOWLEDGED ------------------------OFFICE USE ONLY BELOW THIS LINE------------------------ PERMIT CONDITIONS . . . ZONING: Max Lot Cover % Max Bldg. Height ft SETBACKS: Front Side Rear Basic Plan # Other Covenants SPECIAL CONDITIONS . . . 8 � SANITATION PUBLIC WORKS ON SITE _ LETTER DRAIN TRAFF ENV HEALTH SEWER CN R/R RD IMP OCD ACCESS RSBP LS SLIDE CMBP ESMT RSME STD BLA SLOPE CMME ADDRESS PLBG SP SEPA SITE PLAN CULVERT MBHM 5 ACRE OTHER FIRE AFF/BOND MOVE LOTS OTHER_ _ GRADING INSP 20 ACRE OCP CU FL ZN FML BLA _ PLAT _ _ REZONE SEPA SH LN SP VAR SU VA PLUMBING PERMIT MECHANICAL PERMIT (NOT FOR MOBILE HOMES) FIXTURES No. F3� UNIT TYPE: Electric Oil Gas _ LPG Solar Water Closets Bath Tubs UNIT SIZE: BTU's Aw OOU KW Shower Baths Wash Basins No. FEE Sinks FOR THE INST. OR RELOC. OF Dish Washing Machine �_ Forced Air Systems 'C) D Hot Water Tanks �_ Fuel Storage Tanks Drains Heat Pumps Laundry Washers Wood Stove Laundry Trays Fireplace Insert Urinals —0— Clearance Fireplace Drinking Fountains Rain Leaders Sumps Vacuum Breakers Gas Piping Permit Fee /0 0 Side Sewers Water Service Line Total Due $C��,� G C) Misc L Total Fixtures _ GRADING/FILL INFORMATION F51 Permit Fee No. of cubic yards: Total Due $ 7, 00 To be removed from site Related Bldg. Permit # To be imported to site IF MORE THAN ONE BUILDING, SUBMIT SEPARATE APPLICATION FOR EACH STRUCTURE. A SEPARATE BUILDING PERMIT MUST BE ISSUED FOR EACH BUILDING. r-61 BUILDING DIMENSIONS: MAIN FLOOR MAIN FLOOR SQ. FT. SECOND FLOOR SECOND FLOOR SQ. FT. THIRD FLOOR THIRD FLOOR SQ. FT. FOURTH FLOOR FOURTH FLOOR SQ. FT. MEZZANINE MEZZANINE SQ. FT. BASEMENT BASEMENT SQ. FT. GARAGE GARAGE SQ. FT. CARPORT CARPORT SQ. FT. DECK _ DECK SQ. FT. NUMBER OF FIREPLACES TOTAL SQ. FT. mliIliiiii FOR OFFICE USE ONLY ROUTING SCHED r Bldg sent' \, rcv'd Valuation Site Plan: sent rcv'd Plan Check rcp # San: sent rcv'd Permit Fee Env. Hlth: sent rcv'd Penalty Fee Eng: sent rcv'd Plumbing Fee FM: sent rcv'd Mechanical Fee Env. Cklt Fee TOTAL DUE: city of BAR ItIAINGNI41N NOTIC/EQQandd Inspection Report Address Contractor ✓�—a �I `� Owner i Requested by TYPE OF INSPECTION REQUESTED �❑ BLDG: Pmt. No. ❑ MECH: Pmt. No. ❑ PLBG: Pmt. No. ❑ Footing ❑ Framing ❑ Foundation ❑ Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough-In ❑ Fireplace and Chimney ❑ Furnace Other —` ❑ APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ APPROVED FOR OCCUPANCY subject to certificate of occupancy. ❑ Work listed below has been inspected and approved. ❑ Please contact inspector and arrange for appointment. ❑ Was not able to perform inspection. ❑ CALL 435-5785 FOR REINSPECTION —24 hour notice required. Inspector Date I was present during this inspection. C I T Y O F A R L I N G T 0 N C O N S T R U C T I O N P E R M I T D A T � ar PERMIT NO. � j -- Application is hereby made for permits to do the following work: C 3 New Residence 13 Addition C 3 Duplex C 3 Carport C 3 Remodel C 3 Commercial C 3 Garage C 3 Mobile C 3 Apartment/Condo C 3 Barn C 3 Mechanical C 3 Relocation/Move C 3 Accessory Buildin C 3 Plumbing C 3 Demolition [x Other nn _ No. of buildings :/_ No. of Living Units : Land Use Code: Valuation: Tax Acct. # : Property Address:— /�5Z/9 Aa- Legal Description : Owner: Owner's Addre ss • Builder: Lic. # Builder's Addres6j/ ? ftm: - Architect or Engineer: Applicant's signature: ( w Mar or agent) Permission is hereby granted to do the work described, according to the approved plans and specifications pertaining hereto subject to compliance with the ordinances of the City of Arlington and the State of Washington. The following is a breakdown of your permit fees . 1 . Plan Check Fee(341 .83 .00) . . . . . . . . . . . . . . . . . . . $ 2 . Building Permit Fee(322 . 10. 00) . . . . . . . . . . . . . . $ 3 . Plumbing Permit Fee(322 . 10 . 00) . . . . . . . . . . . . . . S SOD 4 . Mechanical Permit Fee(322 . 10. 00) . . . . . . . . . . . . S 5 . Energy Fee (386 . 00 .02) . . . . . . . . . . . . . . . . S 6 . State Fee (386 . 00 .01) . . . . . . . . . . . . . . . . S 7 . Water/Sewe Fees (see attached breakdown) . . . $_ $ - - -- - . . � �o,pQ . . . . . . . . . . . . . 9 . T O T A L . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 P A I D �''Co C R # � /�Y B Y �! ISSUING OFFICER PROPERTY OWNERS ARE RESPONSIBLE FOR DETERMINING ALL PROPERTY LINE LOCATIONS AND RELATED EASEMENTS . NO OCCUPANCY PERMIT WILL BE ISSUED UNTIL THE INSPECTOR HAS APPROVED THE FINISHED STRUCTURE .