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Home My WebLink About116 N WASHINGTON AVE_1660_2026 CITY OF ARLINGTON BUILDING DEPARTMEfl 1W t':.k GAS PIPING TEST AFFIDAVIT p4j, . 10 1995 omeowner Thomas f;g-(Y OF AHLINGTOri Address 130 North Washington Permit No. 1660 The gas piping system was tested at psi for a total of minutes. WITNESSED B � (signature of occupant requesting gas service) (date) INSTALLED BY 3 / 3 / (si nature 64Astalling gas fitter) (date) Please arrange for someone to be present on the date of requested inspection to provide access for the inspector. The white copy must be mailed upon completion to: City of Arlington - Building Department 238 N. Olympic Arlington, WA 98223 Hard Copy - Job Site Pink Copy - Contractor White Copy - Mail City of Arington NOTICE and Inspection Report Permit No. I2lQ Legal dJ 1 -qz,f,s Date Called J ZZ-7 Address 1 3 d �1+ VIVA I �,4z A Time led l 3a Contractor/Owner By Requested by 1 TYPE OF • REQUESTED ❑ Setback ❑ Roof Diaphragm ❑ Insulation ❑ Plumb GW ❑ Framing ❑ Gas Piping ❑ Footing ❑ Drywall Nailing Final ❑ Foundation ❑ Rough-in Plumbing ❑ Reinspection ❑ Shear Wall ❑ Mechanical ❑_ Other [ A PROVAL ❑ CORRECTION REQUIRED ❑ Coisted 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 r fired. 1 /95 v r b ze.- Inspector ` Date CITY OF ARLINGTON CONSTRUCTION PERMIT ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN NO 1660 PERMIT NO. OWNER MAIL ADDRESS CITY ZIP PHONE Thomas 116 N. Washington Arlington 98223 435-2203 ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N Noethwest Water Heater 2800 Thorndyke Ave Seattle WA 98199 282-4700 NORTHWH103R2 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 $1700. 00 DESCRIBE WORK wall furnace PRUPOSE D USE OF BUILDING SFR tUral 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(RIFT ION Of PROPERTY(SHOWN BELOW OR ATTACH FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK LUr BLOCK - OF WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITYTO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR TAX ID NUMBER LOCAL LAW REGULATING CONSTRUCTION OFTHE PERFORMANCE OF CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE. SIGNATURE OF CONTRACTOR ORAUTHORIZED AGENT DATE 100 ADDRI SS 130 N. Washington X (OFFICE USE ONLY) PLUMBING MECHANICAL NO. TYPE OF FIXTURE FEE NO TYPE OF EQUIPMENT FEE WATER CLOSET (TOILLT) AIR COND UNITS -H,P EA BAIFIIUB REFRIGERATION UNITS - H P EA LAVATORY (WASH BASIN) BOILERS - H.P. EA SHOW'LR GAS FIRED A.C. UNITS -TONNAGE EA, KI 1CHLN SINK& DISP. FORCED AIR SYSTEMS- B.T.0 MEA DISHWASHER 1 WALL HEATERS- B.T,U 65 M LAUNDRY 1 RAY UNI l HEATERS- B.T-U. M CLOIHLSWASHER EVAPORATIVECOOLERS WAILRHEATER CLOTHES DRYERS URINAL VENTILATICN FAN DRINKING FOUNIAIN RANGE FIOOD COMMERCIAL FLOOR DRAIN AIR HANDLING UNIT- CPM VACUUM BREAKERS STOVE ROOF DRAINS - RAINLEADERS METAL FIREPLACE &CHIMNEY SINK (SERVICE - BAR,ETC) WATER HEATER GAS PIPING SUB TOTAL f SUB TOTAL f 12 90 PERMIT $1 PERMIT f TOTAL FEE f TOTAL FEE f SIDL YARD SL IBACK STRLLT SETBACK REAR YARD SETBACK DATE RECEIVED PLAN CHECK FEE FEE RECEIPT NO. USE/ONE LOT AREA VACANT SITE FEES VALUATION FEE ❑YES []NO TYPE OF CONS] OCCUPANCY GROUP NO.OF DWELLING UNITS PLAN CHECKING NG SIZE OF BLDG NO OF STURIk_S MAX.OCC.LOAD BU'LDING f PLUMBING F IRE SPRINKLERS REQUIRED ❑YES ❑NO MECHANICAL STATE BLDG.CODE COMMENTS ENERGY CODE SURCHARGE PENALTY S B.C. SEC.303(a) WATER/SEWER FEES Mechanical Only TOTAL 27 00 PERMIT VION WHEMPIRdt"ILTUD THIS SPA THIS IS YO R PEPAICRSSOR,APPLICANT,TREASURER. BLDG DEPT DATE PY V / T � - �J tI CITY OF ARL,INGTON CONSTRUCTION t Ql (Y " ' LiNGTON PERMIT ❑ COMOINATION ❑ OUILDINO MECHANICAL ❑ PLUMBING SIGIN PERMIT NO. MA LSS city tit1ION N MAIL AOVIT, 61Iv N 1 MAIL Acoff% e 1 • IrcptLIQ kvAtL►.��..� ,A.�Ci,� t-�°-�a�l_.t� z�ra c� T1rc�-c��0 1�.t_. t�, .� ��°I 2 ' - � /a w�1Q� 1 A S RESS Croy tip PITON LK: 104156 IF .-UMOINOCONUACIOR MAIL A RESS CITY Is? rIR7Nf, Nf. LASS CR Mot INI.W ❑ApgITION ,ALTERATION ❑REPAIR ❑L/EM1.11.IIiOm ❑9UILIIIN(',REL(�CATION ALUATION WO IJSCRIK WORK (tr c s- ° vK+o I I IEREBY CERTIrY 11 IAT I HAVE RF,AQ AND EXAMINED THIS APPLICA- _ TION AND KNOW T11E SAME TO BE TRUE AND CORRECT ALL PROVI• I Rr I t ! I H l furl U 11S SIONS OF LAWS ANO ORDINANCES GOVERNINGTI•(IS TYPE OF WORK ,1lI DLtIEk or WILL Rf; COMPI,IEr) WITI I WI(ETHER SPECIFIFD HERIN OR NOT.THE GRANTING OF A PERMIT r)OES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCF.I. TIIE PROVISIONS OF ANY OTHER STATE OR TAX ob Numvick FROM R TV TAX ATEME I.00AL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF CONSTRICTION.PERM17 EXPIRES I YEAR FROM DATE OF ISSUANCE, ` a Sir,"AIURE Cr Gt7M RACTOR OR AUII 400EID ACtNI n/�A79 IITPi'It:u I1til1 n►iI,,T� r'LllliflllN(i __ •�� , _ ,-, _ �_ •�,,,, l:!:IIANICAh - NI>\.'^ I:YI'li UI'PIx9URrs _ 1'IiH tt'$ 'IXT MW No.,_ TYTR OR Boy'P_MRN'P _- rem _ r PIXTURL'i 111ISRE�1.t)til"1'�TOII.I:I]�� _ ,_.....TT•� _ _ IQ CnNn.VNtIS-II.P.RA. M'fllt7Jl1 _ - ST.OD _ BPRI(111RATION IINrM-II.P.11A. rd •IBt"• AVA�WASII DASIN) - %f.00 - _ OIi CRS-Il.r I.P. Jul .itN•• i0V/ if.00 - AS PIRTID A.C.UNITY-TONNAOII l{A� 1 +d�NM•" IOW.RN S- INK MSP05A!• 'ORCP.n AIR SYSI'P,MS-D.T.U. MRALggi =E•a ISIIW _� ALIAITATTSRS••R.T.U. M - tAc ) AbIllL i' �IT.QII _. -- A1INDRYT1tAy - f1.00 -^_ Nrl'IWA1'.CRS-D:r.U• - M S/� - :1.0711115 WA$1IRR i1,orl __ VATORAiwil cool. _ ATi;R(IPJITRR_ _ Tfea _ ;I.0'rillisDItY_RItS. $4.50 1RtNA1, ~` STa+o _ IMLATIAN PAN SLSO 1RINKI(iEil!UUN1'AIN Sf.00 NG81100DCOMMP,Rf TA1. ii30 LIAR IM/11N-_--• - -_ f7• __ .�_ _ 1R IIANDLINO UNIT- CPM VArIlUMHIII{AK1tR3 EGIO .- 1 t)<l1'I)RAINti-IlA1N1.ItM)ISRRISIAI,NIRRPlAC11 A+t:11IMNRY Sd3R INK(SI`,IIVICit- RAlta_TJ_ %7.� A9TTRIILA_1'Elll ___ _ %iS0 . _ - 1 *NP In 3=f)DR,+Iddnl.a S,9f tp,) " •Pqulpmmt IiN mt+d he provide) PrRMPr ! TOTAL l°IILr �� R[ARVARIISETMCK !I�NChtCT: StD 1NU) RAtk SIRt1.13 IpA:16 pATlt1ECD rEE RECEI/TNO. bitM l RI.A A AN1 1 FEES VALUATION FEE ❑YES ❑►+O ir/t 01 CONS1. SX:CU`Rt,)t)► Np.Or blrELl11+G lIN1)S PLAN CHECICING 40 Eu'LAINC 1 SIL!01 m. NU.of STEIRIL3` MAX.000.LOAn PLVMIING t IRE S trlKi.tiSRE0u1Rlu YES NO MECHANICAL STAtf IIWO.CODE COMMENTS ENERGY CODE SUKCIIARGt PENALTY s€c�io�l.t WATE, SEW(R rl POs- "brand fax transmittal mem 767 N oI piigea ► TOTAL lrzhizFri ►EPMIT VAtt"AIION r'� WHI,N PROPERLY YAI IDAtEO RN THIS SPACO TMK IS+t01.IR PERhM1 L RECEN'T fb hon# PA10._ —[.Till ax _1 (+ Fox 0 lj n 1c Eti+in+w nrncuE