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HomeMy WebLinkAbout18323 WOODLANDS WAY_014797_2026 INSPECTION REPORT._ ff ti N GrO � permit No.: dl 7�� Lot #: L ¢ �3�3 Ik c:Lakt J C Q' Address: Cr� Contractor: 9�, ,SD Owner: �,�.� //10.f'l15 41 N G Date: —1 0 APPROVAL ❑ PARTIAL APPROVAL ❑ IOLATION ❑ CORRECTION REQUESTED ❑ Corrections listed below MUST BE MADE before work can be approves, ❑ Please contact inspector. ❑ Was not able to perform inspection. ❑ CALL 435-0674 FOR RE-INSPECTION - 24 hour notice required. Inspector: Date: TYPE OF INSPECTION REQUESTED ❑ Under-floor Framing ❑ Gas Piping ❑ Footing ❑ Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: Permit No,' City nf< ARLINGTON NOTICE and Inspection Report 1,4 Date Called ✓ �/�© Address i Time Called • Contractor By � Owner Requested by TYPE OF INSPECTION REQUESTED ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm Gas Piping ❑ Footing ❑ Framing ❑ Woodstove ❑ Foundation ❑ Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough-In Plumbing ❑ Reinspection ❑ Shear Wall ❑ Furnace ❑ Other ❑ APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION RRECTION REQUIRED orrections listed below MUST BE MADE before work can be approved. / 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. zlS7 11� JO Inspector4�1�z ZDateIV 101C., I was present during this inspection. Permit No. 3 cit,, (,� ItI XV1:r110N NOTICE and InSNection Report Date Called Address �I.(J Time Called Contractor By Owner Requested by TYPE OF INSPECTION REQUESTED ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm Gas Piping ❑ Footing ❑ Framing (/❑ Woodstove ❑ Foundation ❑ Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough-In Plumbing ❑ Reinspection ❑ Shear Wall ❑ Furnace ❑ Other ❑ APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION CORRECTION REQUIRED Corrections listed below MUST BE MADE before work can be approved. ❑ Work listed below has been inspected and approved. ❑ Please contact inspector and arrange for appointment. ❑ Was not able to perform inspection. 2_1 CALL 435-5785 FOR REINSPECTION—24 hour notice required. IV Inspector Date I was present during this inspection. 3�y Cih� n� AitiA�falIN Permit No. NOTICE and Inspection Report Date Called _ Address Time Called Contractor By Owner Requested by TYPE OF INSPECTION REQUESTED ❑ Setback ❑ Reroof ❑ Insulation ❑ Plumb GW ❑ Roof Diaphragm X Gas Piping ❑ Footing ❑ Framing ❑ Woodstove ❑ Foundation ❑ Drywall Nailing ❑ Final ❑ Concrete Slab ❑ Rough-In Plumbing ❑ Reinspection ❑ Shear Wall ❑ Furnace ❑ Other APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTION REQUIRED ❑ Corrections listed below MUST BE MADE before work can be approved. 4;4Work 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. A.,A • was a Inspector Date I was present during this inspection. C I YY OF nRL I N0-rON COhIST RUCT I ON RE RM I T PERM X Y NO_ O 1—z+-7S-7 Owner: WILLIAMS, SHERRI 1832.E WOODLANDS WAY ARLINGTON 98223 Value of Work: $4,000.00 Tax ID: Phone: 360-435-7638 Describe Work: 276 SF PATIO COVER Proposed Use: PATI❑ COVER Legal Description: WOODLANDS SEC 1 DIV D LOT 17 Job Address: 18323 WOODLANDS WAY Contractor's Na_e Type Address License# OWN TOTALS Fee Permit Fee $101.05 Plan Fee �65.68b8 State fee $4.50 TOTAL FEE................. $171.23 I HEREBY __� 'IFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND PAY14ETITS.................. $75. 11 KNOW THE SAME TO BE TRUE AND COR- RECT ALL PROVISIONS OF LAWS AND TOTAL DUE................. $96.12 ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER f-='ED -RE a OR I�_- DATE RECEIPT # I IL G OFFICIAL OCT 3 2001 _ Q ke-- 9UlLFJ;t.G J N�VEO RECEIVED WE l OCT-0 12001Mms - iZ�G ^ � Y� CITY OF ARLINGTON a CITY OF ARLINGTON CONSTRUCTION PERMIT ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN .lf_ PERMIT :1 WNER pp lr cci MAIL AUURESS IIY lip NENO. Nv/ri 71�J 11 ARCIIItECTOROESIGNER MAILAUURESS CITY - ZI/ PHONE L �, N I ) c7e W,3 GENERAL CO AC I VK MAIL ADDRESS CITY LIP PHONE LIC NSE/ MLCIIANICAL CONTRACTOR MAIL ADDRESS CITY LIP PHONE LICENSE / 11f4 PLUMBING CONTRACTOR MAIL ADDRESS city LIP PHONE LICENSE 1 V 4- CLASS OF WORK cc❑NL.W JRAUDITION ❑ALTERATION ❑REPAIR ❑DEMOLI LION ❑BUILDING RELOCATION </yALUAI IUM DFFIIRK Y 1 w w ULS(.RIIBBL yaq II] PRUPOSI U USE UI BUILDING / � '��- I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- w ��� �X TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- Z ll(.nL Uf Sf'RIPI ION UI PHU►�RTY STIO�W,N,�BELOW PR A I IACII F VUR COPY S) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK T PLUCK or ��%�'`��� ��{ WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE a GRANTING OFA PERMIT DOES NOT PRESUMETO GIVEAUTHORITYTO G —G! 7� � VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR n TAX ID NUMBER FROM PROPERTY TAX STATEMENT LOCAL LAW REGULATING CONSTRUCTION OFTHE PERFORMANCE OF CONSTRUCTION.PERMIT EXPIRES 1 YEAR FROM DAT OF ISSUANCE. VxI/VB.I/UURL/SS2 //� /��Jy SIGNATUREEOfa"AACIOROR AUTHORIZED AGENT DATE (OrPICD USRONLY) rLummNO MIECITANICAL, NO. TYPEI OP PIXTURB PHU aY PIXTURIi4 NO. TYPII OP LIOUIPMUNT Pills i'•PIXTURP-3 AT'BR CLOSUr IL13T tR-EOND.UNITS-H.P. PA. d .Bt•" IATTITL'D ITRIOE9tAT10N UNITS-II.P.nA. IgiAp.Ilt•'' AVATORY A.511 BASIN _ N, OR.BRS-ILP.IIA. /grip,list*" 'IIOWE9t WPIRTIDA.C.UNITS-TONNAOBILA. I ti .lit•" ITCIIBN SINK dt DISPOSAL ORCETD AIR SYSTIRMS-B.T.U. META DISHWASHER WALL'IIPATURS-D.T.U. M _ AUNDRY TRAY )NIT I IBATURS-B.T.U. M I,OTTIBS WASIIBR "' WAPORATIVBCOOLMtS ATTIR HEATER LOrrlll'S DRYIMS RINAL _ PNI'I ATION PAW )RINKINO POUNTAIN kANGITHOOD COWMMRCIAL 'IAOR DRAIN AIR ITANDLINO UNI'r CrM VACUUM IIRRAKL'RS sTOVu i00P DRAINS—RAINLEADCRS M9TAL PIRnmAcCR CIIIMNL*Y .INK ORRVICII—BAR,Mr.) ATTTR I IRATE R AS rIrINO '(.p 10 5-$3.00 iddnL -S.75 • ul 'Want list must be erovided SUB TOTAL SUB TOTAL rMMIT PMtMIT TOTAL PPEI TOTAL PB11 5101.YARD SL 1 CK $IRLI,I SL IBACK REAR YARD SEtBACK PLAN CIILCK NUMBLR PLAN CIIECK FEE PIA FEE /` RECELPi NO. USI /U 1 LOT AREA VACANT SITE '' i,��/� �' 790 � ❑YES �D FEES VALUATION FEE t '�IYPL 01 CONS I, OC PANCY JGRUUP NO.OF DWELLING UNITS PLAN CHECKING VG _,5� SI/.L Of 7BLDG. NO.Or S UKIL1 / MAX.000.�AD BU'IDING S / O�.Ins PLUMBING T IRE SPRINKLERS REQUIRED [:]YES NO MECHANICAL COMMENTS STATE BLDG.CODE J1 ENERGY CODE SURCHARGE RECEIVED PENALTY SEC.U.B.C. SEC.3031+1 OCT 0 12001 WATER/SEWER FEES TOTAL CITY OF ARLINGTON PERMIT VALIDATION WHEN PROPERLY VALIDATED ON THIS SPACE)THIS IS YOUR PERMIT d RECEIPT DPAID CRN BY 0 AI rur-ANT T-,-A.':URER. t'.'it L) I7EF'T �' ;IN(�,i;';5t f� CITY OF ARLINGTON CONSTRUCTION PERMIT ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO.00979 OWNER MAIL ADDRESS CITY ZIP PHONE Greg & Sherri Williams 10604 Vernon Rd. Lk Stevens 98258 334-3765 ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE# Turner Construction 18304 N Cedarb.ough Arlington 96223 435--0876 TURNEC*088MN MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE# PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N CLASS OF WORK ❑NEW ❑ADDITION ❑ALTERATION REPAIR ❑DEMOLITION ❑BUILDING RELOCATION VALUATION OF WORK $ 15, 000 DESCRIBE WORK materialVi and e exterior PROPOSED USE OF BOIL ING rpplace damaged 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 DESCRIPTION OF PROPERTY(SHOWN BELOW OR ATTACH FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNINGTHIS TYPE OF WORK LOT D117OCK OF Woodlands, Sector I: WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO 7385-004-017-00 VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR TAX ID NUMBER LOCAL LAW REGULATINGCONSTRUCTION OFTHE PERFORMANCE OF CONSTRUCTION. PER IT PIRES 1 YEAR FROM DATE OF ISSUANCE. SIGNATURE CONTRACTORO TH ZFDAGENT DATE 108 ADDRLSS 18323 Woodlands WayX (OFFICE USE ONLY) MECHANICAL PLUMBING NO. TYPE OF FIXTURE FEE NO. TYPE OF EQU PMENT FEE WATER CLOSET (TOILET) AIR COND UNITS -H.P. E BATHTUB REFRIGERATION UNITS-BTP. EA. LAVATORY (WASH BASIN) BOILERS-H.P. EA SHOWER GAS FIRED A.C. UNITS-TONNAGE EA KI TCHLN SINK& DISP FORCED AIR SYSTEMS- B.T.U. MEA DISHWASHER WALL HEATERS- B T.0 M LAUNDRY TRAY UNIT HEATERS- B.T.U. M CLOTHES WASHER EVAPORAT IVE COOLERS WAIERHEATER CLOTHES DRYERS URINAL VENTILATICN FAN DRINKING FOUN T AIN RANGE HOOD COMMERCIAL FLUOR DRAIN AIR HANDLING UNIT- CPM VACUUM BREAKERS STOVE ROOF DRAINS - RAINLEADERS METAL FIREPLACE &CHIMNEY SINK (SERVICE - BAR,ETC.) WATER HEATER GAS PIPING SUB TOTAL $ SUB TOTAL $ PERMIT ; !�� PERMIT $ TOTAL FEE $ 1 TOTAL FEE $ SIDE YARD SE TBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE FEE RECEIPT NO. USE ZONE LOT AREA VACANT SITE ❑ FEES VALUATION FEE ❑YES NO TYPE OF CONST OCCUPANCY GROUP NO.OF DWELLING UNITS PLAN CHECKING NG SIZE OF BLDG. NO.OF STORIES MAX.00C.LOAD BUILDING $ 162 00 PLUMBING FIRE SPRINKLERS REQUIRED ❑YES ❑NO MECHANICAL COMMENTS STATE BLDG.CODE 4 50 ENERGY CODE SURCHARGE PENALTY U.B.C. SEC.303(a) PAID WATER/SEWER FEES �j q[� TOTAL 16650 C,. ` 1J9Z PERM EITV ATION WHEN PRO VALIDATED (IN THIS SPACE)THIS 15 Y UR ERMIT&RE PAID cc: ASSESSOR,APPLICANT,TREASURER, BLDG. DEPT. k6jKGL DATE RECORDS COPY CITY OT ARLINGTON CONSTRUCTION PERMIT ❑ COMMINAtION IJUILbING ❑ MECHANICAL d PLUMOINO ❑ SIGN Pr-nmu ' N `OWNER MAIL ADDRESS CITY ZI , PROP'. fey �, '.3enw .�'d 21.4,��- l? 4 ARCIII ECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE GEN #ALL C RAC U /M(AIIL ADDRESS / CITY ZIP PHO/NE /Z ,JC NS�EG MECIIANICAL CONTRACTOR MAIL ADDRESS CITY � ZIP I11pN LICENSE 1 PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE I CLASS or WORK 1 []NLW ❑ADDITION [,ALTERATION VRFPAIA ❑DEMOLITION ❑4UILI)ING11E1-OCAT1oN I ALUAtIp OF WORK G E I ESCRIB WORK \/( ✓,�'2�-G-�'y'aY lr% �o�c� .i-�' is! .L��-E.c_'r s.t-� —�a i J� - 7�� � . PRUI'Usl D USE Of BUILDING 1 I-IFRERY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- l1GAl U4 S(RIP)TUN V► PR(TPf.R►V(SHOWN BELOW UR A11A(-I EUUR C.7401-11Lr, c7ION AND KNOW THE SAME TO 13E TRUE AND CORRECT ALL PROVI- SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK -b�BLU(:k or ��-/`E FGWILL OF COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO ' VIOLATE OR CANCEL TILE PROVISIONS OF ANY OTHER STATE OR TAX ID NUMBER LOCAL LAW REGULATING CONSTRUCTION OF THE PEREORMANCF OF �) Cl��7 Y C CONSTRUCTION.PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE. SIGNATURE O ON7RACTpR A IpRIZED AGENT DATE 8 ADURI SS (OFFICE US£ ONLY) PLUMBING MECIIANICAL No. TYPE OF FIXTURE FEE NO. TYPE or EQUIP NT FEE WAILR CLOSE (IOILL 1) AIR COND.UNITS -H.P.EA, BA 1111 UB ' REr RIGERA I ION UNI IS-1I.P.EA. LAVA FURY(WASH BASIN) BOILERS -II.P.EA SIIOW'LR GAS FIRED A.C. UNITS - TONNAGE EA. KI ICI ILN SINK h DISP. FORCED AIR SYSTEMS -B.T.U. MEA L)ISIIWASIILR WALL HEATERS- B.T.U. M LAUNDRY TRAY UNIT IIEAIERS- B.T.U. M CLUIIILS WASIILR EVAPORATIVE COOLERS W'AIER IIEAILR CLOTHES DRYERS URINAL VENTILATION FAN DRINKING FOUNTAIN RANGE I FOOD COMMERCIAL _ 1 LOUR DRAIN AIR IIANDLING UNIT- CPM VACUUM ORLAKERS STOVE ROOF DRAINS - RAINLLADERS METAL FIREPLACE d CIIIMNEY SINK (SERVICE - BAR,E IC.) WATER HEATER GAS PIPING SUBTOTAL 11 SUBTOTAL I PERMIT f I I PERMIT f TOTALFEE f TOTALFEE f SIDLVARDStIBACK SIRLEISE►BACK REAR YARD SETBACK PLAN CIIECK NUMBER PLAN CHECK FEE TEE RECEIPT No. USF l.UN1 LOT AREA VACANT SITE AYES dNo FEES VALUATION FEE TYPL OF CONSI. OCCUPANCY GROUP NO,OF DWELLING UNITS PLAN CHECKING VG f SIZE Of BLDG. NO.OF STORIES MAX.UGC.LOAD BUILDING _ PLUMRING f IRE SPRINKLERS REQUIRED ' E]YES [J No MECHANICAL COMMENTS STATE BLDG.CODE ENERGY CEDE SURCHARGE PENALTY 51C.3 SEC.7031a1 \\4 `',�r WATER/SEWEk LEES TOTAL PERMIT VALIOATION v t� WHEN PROPERLY VALIDATED FIN THIS SPACE)Nit IS YOUR PERMIt A RECEIPT PAID CR4 BY L cc:ASSESSOR.APPLICANT,TREASURER, BLbG. DEPT. BUILOINr,c rnr._+i,i DATE ntconb$ COPY CITY OF ARLINGTON CONSTRUCTION PERMIT ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO.00369 UWNLK M IL ADDRESS CITY ZIP PHONE Andrew K. Culver IH23 Woodland Way 435---6307 ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N SAME MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE F CLASS OF WORK ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑BUILDING RELOCATION VALUATION OF WORK S DESCRIBE WORK Gas Piping for water/heater PROPOSED USE OF BUILDING Residence 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(RIPTION Of PROPERTY(SHOWN BELOW OR ATTACH FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNINGTHIS TYPE OF WORK LOT—BLOCK OF WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITYTO VIOLATE R CANCEL THE PROVISIONS OF ANY OTHER STATE OR TAX ID NUMBER LOCH A REGULAT CONSTRUCTION OFTHE PERFORMANCE OF CO TR CTION. PE MI EXPIRES 1 YEAR FROM DATE OF ISSUANCE. SIG 7U FCONTRACTO O UTHORMAGENT DATE JOB ADDRLSS Same as alcove (OFFICE USE ONLY) PLUMBING MECHANICAL NO TYPE OF FIXTURE FEE NO. TYPE OF EQUIPMENT FEE WATER CLOSET (TOILET) AIR COND.UNITS —H.P. EA. BAIHIUB REFRIGERATION UNITS—H P. EA LAVATORY (WASH BASIN) BOILERS—H.P EA SHOWLR GAS FIRED A.C. UNITS—TONNAGE EA KI ICHLN SINK & DISP FORCED AIR SYSTEMS— B.T.0 MEA DISHWASHER WALL HEATERS— B.T.0 M LAUNDRY TRAY UN11 HEATERS— B.T.U. M CLOTHES WASHER EVAPORAII'VE COOLERS WATER HEATER CLOTHES DRYERS URINAL VENTILATICN FAN DRINKING FOUNTAIN 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 SUBTOTAL S SUBTOTAL $1 LS0 PERMIT ; PERMIT f 15 100 TOTAL FEE $1 TOTAL FEE $1 24 150 SIDE YARD SE I BACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE FEE RECEIPT NO. USE LONE LOT AREA VACANT SITE ❑YES ❑NO FEES VALUATION FEE TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS PLAN CHECKING NG SIZE OF BLDG. NO.OF STORIES MAX.000.LOAD BUILDING $ PLUMBING FIRE SPRINKLERS REQUIRED ❑YES ❑NO MECHANICAL 2450 COMMENTS STATE BLDG.CODE ENERGY CODE SURCHARGE PENALTY U.B.C. SEC.303(a) Mechanical Only WATER/SEWER FEES TOTAL 24 50 PERMIT VAIJ ATION WHEN PROP D (IN THIS SPACE) THIS IS YOUR PT Z PAID BY cc:ASSESSOR,APPLICANT,TREASURER, BLDG. DEPT. UILD OFFICIAL r DATE RECORDS COPY CITY OF ARLINGTON CONSTRUCTION PERMIT ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL PLUMBING ❑ SIGN PERMIT NO. /� MAIL ADDRESS CI Y � ► / �i`f�6� � 21P PHDNE �RE�CTOESIGNER MAIL ADDRESS CITY ZIP PHONE bNERAL CONTRACTOR MAIL ADDRESS CITY PHONE �"� ZIP LIC NSE If MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE#' PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE M CLASS OF WORK ❑NLW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑BUILDING RELOCATION VALUATION OF WORK f ESLRIBE WORK 627 IL- �,rQ leRUPOSt D USE Of BUILDING f� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA- TION UESCRIPIIUN Of PROPERTY(SHOWN BELOW OR ATTACH FOUR COPIES) TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI- SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK LDr BLOCK OF WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE GRANTING OF PERMIT DOES NOT PRESUME TO GIVE AUTHORITYTO TAX ID NUMBER VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OFTHE PERFORMANCE OF CONSTRUCTION,PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE. S 08 AIUURESS SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE (OFFICE USE ONLY) PLUA ING MECHANICAL NO. TYPE OF FIXTURE FEE NO. WAT CLUSEI (TOILEI) TYPE OF EQUIPMENT FEE BA I H I Ub�,, AIR COND, UNITS -H.P. EA. LAVATORY 'ASIi BASIN) REFRIGERATION UNITS -H.P.EA. SHOWER \ BOILERS-H.P.EA ASII GAS FIRED A.C.UNITS-TONNAGE EA. KI SINK& DfS{'.DISHWASHER FORCED AIR SYSTEMS- B.T.U. MEA LAUN ER \ WALL HEATERS- B.T.U. M LAUNDRY 1 RAY UNIT HEATERS- B.T.U. M CLOIIIES WASHER EVAPORATIVE COOLIE RS WAIERIIEATLR CLOTHES DRYERS URINAL \ VENTILATION FAN FLOUR DRAININ DRINKING IAIN RANGE HOOD COMMERCIAL VACUUM BREAKERS AIR HANDLING UNIT- CPM ROOF DRAINS - RAINLEAUERS STOVE SINK (SERVICE- BAR,ETC.) METAL FIREPLACE&CHIMNEY j WATER HEATER GAS PIPING SUBTPERMOTAL $ SUBTOTAL $ S� IT $ PERMIT f TOTAL FEE f TOTAL FEE SIUL YARD SE 1 BACK STREET SETBACK f REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE USE /.ONt LOT AREA VACANT SITE FEE RECEIPT NO. ❑YES NO FEES VALUATION FEE TYPE OF CONST, OCCUPANCY GROUP NO.OF DWELLING UNITS PLAN CHECKING VG SILL OF SLUG. NO.OF STORILS MAX.OCC.LOAD BUILDING f PLUMBING FIRE SPRINKLERS REQUIRED ❑YES ❑NO . MECHANICAL // COMMENTS STATE BLDG.CODE ZT• ENERGY CODE SURCHARGE PENALTY U.BC. / SEC.303(a) WATER/SEWER FEES TOTAL PERMIT VALIDATION WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT&RECEIPT s PAID CR# BY cc:ASSESSOR,APPLICANT,TREASURER,BLDG. DEPT. BUILDING OFFICIAL DATE RECORDS COPY