HomeMy WebLinkAbout114 N Olympic Ave_BLD6143_2026 OPERATING PERMIT APPLICATION
Community&Economic Development
City of Arlington• 18204 59th Ave NE•Arlington,WA 98223 •Phone(360) 403-3551
Part I
Property Address for which Operating Permit is requested: 114 N Olympic Avenue
Parcel ID No.: Current Occupancy Legion Park
Project Description: City of Arlington event, Sept 28, 2024
Applicant Name: Sarah Lopez Home No.: 360-403-3448
Email Address: slopez@arlingtonwa.gov Cell No.:
Mailing Address: 238 N Olympic Ave City: Arlington State: WA Zip: 98223
Contact Person: Phone No.:
Part II
Type of Operating Permit
An Operating Permit is required to conduct any activity or to use any class of building listed below. Please indicate
the type(s) of Operating Permit(s) requested by checking each applicable box. (If you require assistance,or would
like more information,contact the City of Arlington Building Department at 360-403-3551.)
❑ Manufacturing,storing or handling hazardous materials in quantities exceeding those listed in the Fire Code
(see Appendix A.) Identify the materials and quantities and describe the manner in which the materials will be
manufactured,stored or handled (attach additional sheets if necessary):
❑ Conducting a hazardous process or activity,including,but not limited to,any commercial or industrial
operation which produces combustible dust as a byproduct,fruit and crop ripening,waste handling,spray
operations,and high-piled storage (see Appendix B.) Describe the process(es) or activity(ies)to be conducted
(attach additional sheets if necessary):
REV032021 Pagel of 3
❑ Use of pyrotechnic devices in assembly occupancies (see Appendix C.) Describe the devices to be used and type
of event(attach additional sheets if necessary):
❑Aboveground Storage Tank(AST) (see Appendix D)
❑ Removal ❑ Decommissioning ❑ Temporary tank closure ❑ Changes in service
❑ Permanent tank closure
Brief description:
❑ Underground Storage Tank(UST) (see Appendix D)
❑ Removal ❑ Decommissioning ❑ Temporary tank closure ❑ Changes in service
❑ Permanent tank closure
Brief description:
Temporary Membrane Structures, including tents and canopies (see Appendix E.) Brief description of structure
and use: 2- 20X20ft canopy tents, no sides, rented from Pacific Party Canopies. Same type
use for Hometown Holidays in the past. 300 lb weights each leg.
❑ Special Event Operating Permit-An Operating Permit is required for any special event that takes place within
an occupied building, or an outdoor mass gathering,which is outside the scope of the permitted use (see Appendix
F.) Brief description of type of gathering proposed:
❑ Mobile Vendor- (see Appendix G.) Brief description of vehicle and use:
Part III
Premises/Building Information
1. Date of last inspection of Premises:
2. Has a Certificate of Occupancy been issued for the premises? ❑Yes ❑No
Type: ❑ Permanent❑ Temporary Date of Issuance:
REV032021 Page 2of3
3. Are there currently any open Building Permits associated with the premises? ❑Yes Q No
If yes,please describe (attach additional sheets if necessary):
4. Additional Comments:
SIGNATURE OF APPLICANT
I herby certify that the foregoing information (and all information in attached sheets,if any) is true and complete.
Sarah Lopez Date:l02408.ned 9y Sarah 8-07'Lopez
8/29/24
Date:2024.08.29 09:32:28-0T00'
Signature of Applicant or Authorized Representatives Signature Date
Sarah Lopez, Community Engagement Director
Name and Title (if applicable) of person signing Application(Please print)
Part IV
To be completed by the City of Arlington Building Department
Inspection Required: ❑Yes ❑ No
Inspections Performed: ❑Yes ❑NOD Date of Inspection:
Tests or Reports required verifying compliance? ❑Yes ❑No
If YES,have Tests or Reports been received? ❑Yes ❑No
OPERATING PERMIT APPROVED
Operating Permit Issued by:
Date Operating Permit Issued: Date Operating Permit Expires:
Type/Description of Operating Permit:
Conditions of Operating Permit(list conditions here AND in the space provided in the Operating Permit:
Additional Comments: (Attach additional pages if needed)
REV032021 Page 3of3
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2-20 x 20 ft tents
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OPERATING PERMIT APPLICATION
Community&Economic Development
City of Arlington• 18204 59th Ave NE•Arlington,WA 98223 •Phone(360)403-3551
Part I
Property Address for which Operating Permit is requested: 114 N Olympic Avenue
Parcel ID No.: Current Occupancy Legion Park
Project Description: City of Arlington event, Sept 28, 2024
Applicant Name: Sarah Lopez Home No.: 360-403-3448
Email Address: slopez@arlingtonwa.gov Cell No.:
Mailing Address: 238 N Olympic Ave City: Arlington State: WA Zip: 98223
Contact Person: Phone No.:
Part II
Type of Operating Permit
An Operating Permit is required to conduct any activity or to use any class of building listed below.Please indicate
the type(s) of Operating Permit(s) requested by checking each applicable box. (If you require assistance,or would
like more information,contact the City of Arlington Building Department at 360-403-3SS1.)
❑ Manufacturing,storing or handling hazardous materials in quantities exceeding those listed in the Fire Code
(see Appendix A.) Identify the materials and quantities and describe the manner in which the materials will be
manufactured,stored or handled (attach additional sheets if necessary):
❑ Conducting a hazardous process or activity,including,but not limited to,any commercial or industrial
operation which produces combustible dust as a byproduct,fruit and crop ripening,waste handling,spray
operations,and high-piled storage (see Appendix B.) Describe the process(es) or activity(ies)to be conducted
(attach additional sheets if necessary):
ii REV032021 AUG"UG 2 9 2024
Pagel of 3
--.....�.......1PA+? .....
❑ Use of pyrotechnic devices in assembly occupancies (see Appendix C.) Describe the devices to be used and type
of event(attach additional sheets if necessary):
❑Aboveground Storage Tank(AST) (see Appendix D)
❑ Removal ❑ Decommissioning ❑ Temporary tank closure ❑ Changes in service
❑ Permanent tank closure
Brief description:
❑ Underground Storage Tank(UST) (see Appendix D)
❑ Removal ❑ Decommissioning ❑ Temporary tank closure ❑ Changes in service
❑ Permanent tank closure
Brief description:
❑✓ Temporary Membrane Structures,including tents and canopies (see Appendix E.) Brief description of structure
and use: 2- 20X2Oft canopy tents, no sides, rented from Pacific Party Canopies Same type
use for Hometown Holidays in the past.300 lb weights each leg.
❑Special Event Operating Permit-An Operating Permit is required for any special event that takes place within
an occupied building,or an outdoor mass gathering,which is outside the scope of the permitted use (see Appendix
F.) Brief description of type of gathering proposed:
❑ Mobile Vendor- (see Appendix G.) Brief description of vehicle and use:
Part III
Premises/Building Information
1. Date of last inspection of Premises:
2. Has a Certificate of Occupancy been issued_for the premises? ❑Yes ❑No
Type: ❑ Permanent❑ Temporary Date of Issuance:
REV032021 Page 2 of 3
3. Are there currently any open Building Permits associated with the premises? QYes [D No
If yes,please describe(attach additional sheets if necessary):
4. Additional Comments:
SIGNATURE OF APPLICANT
I herby certify that the foregoing information (and all information in attached sheets,if any) is true and complete.
Digitally signed by Sarah Lopez 8/29/24
Sarah Lopez Date:2024.08.29 09:32:28-07'00'
Signature of Applicant or Authorized Representatives Signature Date
Sarah Lopez, Community Engagement Director
Name and Title(if applicable)of person signing Application(Please print)
Part IV
To be completed by the City of Arlington Building Department
Inspection Required: XfYes No
Inspections Performed: ❑Yes WNoff7 Date of Inspection:
Tests or Reports required verifying compliance? ❑Yes E]No
If YES,have Tests or Reports been received? ❑1'es 5�No
OPERATING PERMIT APPROVED
Operating Permit Issued by: VI0
Date Operating Permit Issued: p ` Date Operating Permit Expires: g130�Z�
Type/Description of Operating Permit: 2 242 Kzd -ref-ftS ZoPEWZ
Conditions of Operating Permit(list conditions here AND in the space provided in the Operating Permit:
�G ► 3 �WS K-►oAJ ?�r1IOC-0 t�!61'
I� � 4CP i!c'�i''�Es iP "IEI�I�S_
Additional Comments: (Attach additional pages if needed)
REV032021 Page 3 of 3
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Permit#: 6143
Permit Date: 08/30/24
Permit Type: OPERATING
Project Name: City of Arlington Event
Applicant Name: Sarah Lopez
Applicant Address: 238 N Olympic Ave
Applicant, City, State, Zip: Arlington, WA 98223
Contact: Sarah Lopez
Phone: 360 403 3448
Email: slopez@arlingtonwa.gov
Scope of Work: 2 20' x 20' canopy tents with no sides
Valuation: 0.00
Square Feet: 800
Number of Stories: 1
Construction Type:
Occupancy Group:
ID Code:
Permit Issued:
Permit Expires:
Form Permit Type: OPERATING
Status: IN PROCESS
Assigned To: Kristin Foster
Property
Parcel# Address Legal Description Owner Name Owner Phone Zoning
CITY OF 940 OPEN
31051100100600 114 N OLYMPIC AVE ARLINGTON SPACE/PARKS
Plan Reviews
Date Review Type Description Assigned To Review Status
08/30/2024 ASSESSORY DWELLING BUILDING In Review
UNIT
08/30/2024 ASSESSORY DWELLING FIRE In Review
UNIT
Fees
Fee Description Notes Amount
Processing/Technology $25.00
Total $25.00
Uploaded Files
Date File Name
08/30/2024 22221602-20240829 BLD6143 Application.pdf
08/30/2024 22221603-20240829 BLD6143 SiteMap;pdf
From: Steve Goforth
To: Kristin Foster;Sarah Lopez
Subject: Re:City of Arlington Event Operating Permit-BLD 6143
Date: Thursday,September 12,2024 2:32:12 PM
Attachments: image001.Dng
Outlook-xdvil0x5.Dng
This message is from an External Sender
This message came from outside the City of Arlington
Kristin
I am okwith us issuing the permit per our conversation.
Thankyou
Steve Goforth, Assistant Chief/Community Risk Reduction
North County Regional Fire Authority
8117 267111 St NW Stanwood,WA 98292
Office 360-629-2184 x105
Cell 360-502-6184
sgoforth@northcountyfireems.com
"Serving our Communities with Compassion"
Serving the Cities of Arlington and Stanwood,the rural communities of Bryant, Freeborn,Warm Beach,
Kayak Point and the Stillaguamish Tribe of Indians.
CONFIDENTIALITY NOTICE-This e-mail message,including any attachments,is for the sole use of the intended
recipient(s)and may contain confidential,proprietary,and/or privileged information protected by law. If you are
not the intended recipient,you may not use,copy,or distribute this e-mail message or its attachments. If you
believe you have received this e-mail message in error, please contact the sender by reply e-mail and telephone
immediately and destroy all copies of the original message.Thank you
From: Steve Goforth <sgoforth@northcountyfireems.com>
Sent:Thursday, September 12, 2024 2:30 PM
To: Kristin Foster<kfoster@arlingtonwa.gov>
Subject: Re: City of Arlington Event Operating Permit- BLD 6143
From: Kristin Foster<kfoster@arlingtonwa.gov>
Sent:Thursday, September 12, 2024 2:23 PM
To: Steve Goforth <sgoforth@northcountyfireems.com>
Subject: City of Arlington Event Operating Permit- BLD 6143
•--------------------------------------------------------------------------------------------------------------------------------------------------------
;CAUTION : This email originated from outside of the organization. Do not click links or open attachments;
unless you recognize the sender and know the content is safe
-------------------------------------------------------------------------------------------------------------------------------------------------------
Hello,
Sarah Lopez said she talked to you about your review comments on this operating permit for the two
tents. Is she planning to resubmit information for review or are you ok with issuing per your
conversation.Thanks!
40 Kristin Foster
Permit Technician II
Community and Economic Development
18204 59th Ave NE,Arlington,WA 98223
P.(360)403-3545
E.kfoster(@arlingtonwa.gov
PERMIT FEE WAIVER REQUEST
• • Community&Economic Development
- City of Arlington• 18204 59th Ave NE•Arlington,WA 98223 •Phone(360)403-3551
PER THE CURRENT FEE RESOLUTION
Section 1. Fees and Charges—General.
1.1 Fees. Fees are intended to cover the normal, recurring costs associated with providing a
given service. Fees are non-refundable.
1.2 Prices. In some instances, the City provides certain goods and merchandise for sale. Prices
for these goods may be included in this resolution.
1.3 Payment Due. Fees are due at the time the action is requested (e.g., at time of application)
or occurs (e.g., prior to a specific action). An applicant may pay all fees of a multi-phased
project in advance; however, doing so does not vest applicable fees due. Fees due are those
in effect at the time the specific action or phase of an action is requested or occurs.
1.4 Waivers. Upon petition by the applicant, the City Council may waive any of the fees, or
portions thereof, for any non-profit organization or government agency.
NOTE. State Surcharge Fees cannot be waived.
Permit Number: BLD-6143 Total Amount: $ 175.00
Staff Requesting Fee Waiver: Sarah Lopez Staff Department: Administration
Staff Email: slopez@arlingtonwa.gov Staff Phone#: 360-403-3448
Reason for Waiver: City project: Hispanic Heritage Event Tent operating permit fee
Council Workshop Date: Council Approval Date: 01/06/2025
Signatory Authority:
Print Name: sfiah Lopez
CED STAFF USE ONLY
FEE BREAKDOWN
Plan Review Fee(s) $
Permit Fee(s) $ 150.00
Processing Technology Fee $ 25.00
State Surcharge Fee $
Other: $
Other: $ ACCEPTED BY DATE STAMP
REV5.2021 Page 1 of 1
i
PERMIT FEE WAIVER REQUEST
• Community&Economic Development
City of Arlington• 18204 59th Ave NE•Arlington,WA 98223 • Phone(360) 403-3551
PER THE CURRENT FEE RESOLUTION
Section 1. Fees and Charges—General.
1.1 Fees. Fees are intended to cover the normal, recurring costs associated with providing a
given service. Fees are non-refundable.
1.2 Prices. In some instances, the City provides certain goods and merchandise for sale. Prices
for these goods may be included in this resolution.
1.3 Payment Due. Fees are due at the time the action is requested (e.g., at time of application)
or occurs (e.g., prior to a specific action). An applicant may pay all fees of a multi-phased
project in advance; however, doing so does not vest applicable fees due. Fees due are those
in effect at the time the specific action or phase of an action is requested or occurs.
1.4 Waivers. Upon petition by the applicant, the City Council may waive any of the fees, or
portions thereof, for any non-profit organization or government agency.
NOTE. State Surcharge Fees cannot be waived.
Permit Number: BLD-6696 Total Amount: $ 175.00
Staff Requesting Fee Waiver: Sarah Lopez Staff Department: Admin
Staff Email: slopez@arlingtonwa.gov Staff Phone #: 360-403-3448
Reason for Waiver: Operating permit for Hispanic Heritage special event
Council Workshop Date: 10/06/2025 Council Approval Date: 10/06/2025
Sarah Loll@Z Digitally signed by Sarah Lopez
Signatory Authority: N Date:2025.10.07 08:50:56-07'00'
Print Name: Sarah Lopez, Community Engagement Director
CED STAFF USE ONLY
FEE BREAKDOWN
Plan Review Fee(s) $
Permit Fee(s) $ 150.00
Processing Technology Fee $ 25.00
State Surcharge Fee $
Other: $
Other: $ ACCEPTED BY DATE STAMP
REV5.2021 Page 1 of 1
Tents & Temporary Membrane Structures
Scope and Purpose
This information handout is intended to inform and educate event organizers,tent rental companies
and others interested in using a "Tent and or other Membrane Structures" of the codes and standards
enforced by North County RFA
Notice: It is the responsibility of the event organizer to provide a copy of this document to all hot food
vendors participating in their event/activity.
Definitions
Tent—a structure, enclosure, or shelter,with or without sidewalls or drops, constructed of fabric or
pliable material supported in any manner except by air or the contents that it protects.
Membrane Structures—an air-inflated, air-supported, cable or frame-covered structure as defined by
the International Building Code and not otherwise defined as a tent.
Temporary—tents, air-supported, air-inflated, or tensioned membrane structures shall not be erected
for a period of more than 180 days within a 12-month period on a single premise.
Permits Required
A permit is required to operate an air-supported temporary membrane structure, a temporary stage
canopy, or a tent having an area in excess of 400 square feet.
Exceptions:
1. Tents used exclusively for recreational camping purposes.
2.Tents open on all sides,which comply with all of the following:
2.1. Individual tents having a maximum size of 700 square feet.
2.2.The aggregate area of multiple tents placed side by side without a fire break clearance of
not less than 12 feet shall not exceed 700 square feet total.
2.3. A minimum clearance of 12 feet to structures and other tents shall be provided.
North County RFA 360-502-6184 www.northcountyfireems.com
Tent Permit Application Requirements
• Manufacturer Specifications
o Structural Stability and Anchoring Specifications (staking the tent will be required unless
manufacturers' specifications and/or engineering can be provided to show how it will be ballasted
properly).
• Certificate of Flame Resistance-all tents and their; sidewalls, drops, floor coverings, and decorative
materials, shall meet the flame propagation performance criteria.
• Floor plan is required for tents with an occupant load of 50 or more and shall show;
o Number of tent walls
o Location of Exits(include size,type, etc.),
o Location of fire extinguishers (minimum 2-A: 10;
B:C)with current service tag.
o "No Smoking" signs,
o Diagram of interior including; location of chairs,
tables, merchandise, and occupant load, (15
square feet per person for events with tables
and chairs, seven square feet per person
without tables and chairs, occupant load sign
shall be posted).
o Cooking and/or open flames.
o Heaters and ventilation.
• Site plan is required and shall show the following;
o Number of tents.
o Size of all tents.
o Occupant load for each tent.
o Tent location in reference to fire apparatus access, lot lines, buildings, other tents, and
parked vehicles (when determining required distances, support ropes and guy wires shall be
considered as part of the tent).
o Locations of generators (generators shall be a minimum of 20'feet from the tent).
c 40 YSOoat�eant
ra
(9 0
O O a
o � o
North County RFA 360-502-6184 www.northcounlyfireems.com
Staking Requirements
Under circumstances where the manufacture specifications cannot be located, '
or does not specify minimum staking requirements,the following shall apply: '
i
• Stake dimensions- 1" x 36",driven down to full anchor depth. '
• One stake per leg
• Two stakes per corner adjacent to each other.
• Stakes shall be driven straight down,not angled.
• Stakes shall be driven in the ground Y,the distance of the leg height from ,
the tent.
Example: If the legs are eight-foot-tall then the stakes shall be
driven in 4'from the base of the leg
• Tent feet shall be installed on each leg.
• These requirements may only be used for tents with a maximum square footage of 4,000
square feet.
Ballasting Requirements
The minimum ballasting requirements shall be specified in the tents manufacturing specifications or an
engineering report shall be provided showing the proposed ballasted weight is appropriate for the tent
size and wind loads. Under circumstances where the manufacturer specifications cannot be located or
do not specify minimum ballasting requirements and an engineering report cannot be provided the tent
shall be staked as per the manufactured specifications
Exception:with the Fire Marshal's approval, tents with a maximum square footage of 4,000 square feet
shall have the minimum ballasting requirements as follows: • Minimum ballast weight used shall be
1,200 pounds per leg. • Corner shall have two 1,200 pounds ballast weights in place adjacent to each
other. • Anchor points shall be Yz the distance of the leg height from the tent. •Tent feet shall be
installed on each leg.
Straps/Ropes
Straps shall meet the following requirements:
• Ropes are not acceptable only ratchet nylon webbing straps with tensile strength rating shall
be used to secure all tents.
• All methods of securing straps to anchors shall meet the same or greater working loads as
specified by the manufacturer. If the manufacturer does not provide working loads, 1,200
pounds or greater shall be used.
• Webbing straps shall be free of tears or excessive frays.
North County RFA 360-502-6184 1 www.northcounlyfireems.com
i
PERMIT FEE WAIVER REQUEST
• Community&Economic Development
City of Arlington• 18204 59th Ave NE•Arlington,WA 98223 • Phone(360) 403-3551
PER THE CURRENT FEE RESOLUTION
Section 1. Fees and Charges—General.
1.1 Fees. Fees are intended to cover the normal, recurring costs associated with providing a
given service. Fees are non-refundable.
1.2 Prices. In some instances, the City provides certain goods and merchandise for sale. Prices
for these goods may be included in this resolution.
1.3 Payment Due. Fees are due at the time the action is requested (e.g., at time of application)
or occurs (e.g., prior to a specific action). An applicant may pay all fees of a multi-phased
project in advance; however, doing so does not vest applicable fees due. Fees due are those
in effect at the time the specific action or phase of an action is requested or occurs.
1.4 Waivers. Upon petition by the applicant, the City Council may waive any of the fees, or
portions thereof, for any non-profit organization or government agency.
NOTE. State Surcharge Fees cannot be waived.
Permit Number: BLD-6143 Total Amount: $ 175.00
Staff Requesting Fee Waiver: Staff Department:
Staff Email: Staff Phone #:
Reason for Waiver:
Council Workshop Date: Council Approval Date:
Signatory Authority:
Print Name:
CED STAFF USE ONLY
FEE BREAKDOWN
Plan Review Fee(s) $
Permit Fee(s) $ 150.00
Processing Technology Fee $ 25.00
State Surcharge Fee $
Other: $
Other: $ ACCEPTED BY DATE STAMP
REV5.2021 Page 1 of 1
Permit#: 6143
Permit Date: 08/30/24
Permit Type: OPERATING
Project Name: City of Arlington Event
Applicant Name: Sarah Lopez
Applicant Address: 238 N Olympic Ave
Applicant, City, State, Zip: Arlington,WA 98223
Contact: Sarah Lopez
Phone: 360 403 3448
Email: slopez@arlingtonwa.gov
Scope of Work: 2 20' x 20' canopy tents with no sides
Valuation: 0.00
Square Feet: 800
Number of Stories: 1
Construction Type:
Occupancy Group:
ID Code:
Permit Issued: 09/20/2024
Permit Expires: 03/19/2025
Form Permit Type: OPERATING
Status: COMPLETE
Assigned To: Kristin Foster
Property
Parcel# Address Legal Description Owner Name Owner Phone Zoning
31051100100600 114 N OLYMPIC AVE CITY OF 940 OPEN
ARLINGTON SPACE/PARKS
Inspections
Date Inspection Type Description Scheduled Date Completed Date Inspector Status
09/23/2024 Inspection 09/27/2024 09/27/2024 BUILDING Approved
09/23/2024 Inspection 09/27/2024 FIRE Assigned
Plan Reviews
Date Review Type Description Assigned To Review Status
08/30/2024 OPERATING Approved pending Fire approval. BUILDING Approved with
Conditions
09/03/2024 OPERATING Approved FIRE Approved
Notes
Date Note Created By:
O1/08/2025 Operating permit fee of$175.00 was approved by City Council on 1/6/2025. Kristin Foster
09/12/2024 Emailed Steve to verify if he needs additional information to be submitted or if I can move Kristin Foster
forward with issuance.
09/11/2024 Emailed the Fire Departments comments and hand out. Kristin Foster
09/11/2024 Sarah emailed and said she spoke with Steve Goforth. Kristin Foster
Uploaded Files
Date File Name
08/30/2024 22221603-20240829 BLD6143 SiteMap.pdf
08/30/2024 22221602-20240829 BLD6143 Application.pdf
Item:
Cityof Arlington NB #5
g Attachment
Council Agenda Bill G
COUNCIL MEETING DATE:
January 6, 2025
SUBJECT:
Request to Waive Operating Permit Fee for event tent
ATTACHMENTS:
Permit Application and Permit Fee Waiver Request
DEPARTMENT OF ORIGIN
Administration; Paul Ellis, City Administrator
EXPENDITURES REQUESTED: 0
BUDGET CATEGORY: N/A
BUDGETED AMOUNT:
LEGAL REVIEW:
DESCRIPTION:
Request to waive operating permitting fee of $175.00 for tent/canopy for Hispanic Heritage event in
October of 2024.
HISTORY:
Historically, permit fees have been waived for City projects.
ALTERNATIVES:
Remand to staff for additional information.
RECOMMENDED MOTION:
I move to approve waiving permitting fee for the event canopy.
OPERATING PERMIT APPLICATION
\ Community&Economic Development
City of Arlington• 18204 59th Ave NE•Arlington,WA 98223 • Phone(360)403-3551
Part I
Property Address for which Operating Permit is requested: 114 N Olympic Avenue
Parcel ID No.: Current Occupancy Legion Park
Project Description: City of Arlington event, Sept 28, 2024
Applicant Name: Sarah Lopez Home No.: 360-403-3448
Email Address: slopez@arlingtonwa.gov Cell No.:
Mailing Address: 238 N Olympic Ave City: Arlington State: WA Zip: 98223
Contact Person: Phone No.:
Part II
Type of Operating Permit
An Operating Permit is required to conduct any activity or to use any class of building listed below.Please indicate
the type(s) of Operating Permit(s) requested by checking each applicable box. (If you require assistance,or would
like more information,contact the City of Arlington Building Department at 360-403-3SS1.)
❑ Manufacturing,storing or handling hazardous materials in quantities exceeding those listed in the Fire Code
(see Appendix A.) Identify the materials and quantities and describe the manner in which the materials will be
manufactured,stored or handled (attach additional sheets if necessary):
❑ Conducting a hazardous process or activity,including,but not limited to,any commercial or industrial
operation which produces combustible dust as a byproduct, fruit and crop ripening,waste handling,spray
operations,and high-piled storage(see Appendix B.)Describe the process(es)or activity(ies)to be conducted
(attach additional sheets if necessary):
�i
REV032021 AUG 2 9 2024 Pagel of 3
❑ Use of pyrotechnic devices in assembly occupancies (see Appendix C.) Describe the devices to be used and type
of event(attach additional sheets if necessary):
❑Aboveground Storage Tank(AST) (see Appendix D)
❑ Removal ❑ Decommissioning ❑ Temporary tank closure ❑ Changes in service
❑ Permanent tank closure
Brief description:
❑ Underground Storage Tank(UST) (see Appendix D)
❑ Removal ❑ Decommissioning ❑ Temporary tank closure ❑ Changes in service
❑ Permanent tank closure
Brief description:
❑✓ Temporary Membrane Structures,including tents and canopies (see Appendix E.) Brief description of structure
and use: 2- 20X2Oft canopy tents, no sides, rented from Pacific Party Canopies Same type
use for Hometown Holidays in the past.300 lb weights each leg.
❑Special Event Operating Permit-An Operating Permit is required for any special event that takes place within
an occupied building,or an outdoor mass gathering,which is outside the scope of the permitted use (see Appendix
F.) Brief description of type of gathering proposed:
❑ Mobile Vendor- (see Appendix G.) Brief description of vehicle and use:
Part III
Premises/Building Information
1. Date of last inspection of Premises:
2. Has a Certificate of Occupancy been issued_for the premises? ❑Yes ❑No
Type: ❑ Permanent❑ Temporary Date of Issuance:
REV032021 Page 2 of 3
3. Are there currently any open Building Permits associated with the premises? QYes Q✓ No
If yes,please describe(attach additional sheets if necessary):
4. Additional Comments:
SIGNATURE OF APPLICANT
I herby certify that the foregoing information (and all information in attached sheets,if any) is true and complete.
Sarah Lo ez Digitally signed Sarah Lopez 8/29/24
I) Date:2024.08.29 09:32:28-07'00'
Signature of Applicant or Authorized Representatives Signature Date
Sarah Lopez, Community Engagement Director
Name and Title(if applicable)of person signing Application(Please print)
Part IV
To be completed by the City of Arlington Building Department
Inspection Required: XfYes R No
Inspections Performed: ❑Yes ENoi] Date of Inspection:
Tests or Reports required verifying compliance? ❑Yes E]No
If YES,have Tests or Reports been received? ❑Yes No
OPERATING PERMIT APPROVED
Operating Permit Issued by: V—I.
Date Operating Permit Issued: Date Operating Permit Expires: g1304-1
Type/Description of Operating Permit: ?_— 2o�f[zo� TEAS �O���l
Conditions of Operating Permit(list conditions here AND in the space provided in the Operating Permit:
�G nol.-&3 'wSP&'n-CtoAJ
Additional Comments: (Attach additional pages if needed)
REV032021 Page 3 of3
i
PERMIT FEE WAIVER REQUEST
• Community&Economic Development
City of Arlington• 18204 59th Ave NE•Arlington,WA 98223 • Phone(360) 403-3551
PER THE CURRENT FEE RESOLUTION
Section 1. Fees and Charges—General.
1.1 Fees. Fees are intended to cover the normal, recurring costs associated with providing a
given service. Fees are non-refundable.
1.2 Prices. In some instances, the City provides certain goods and merchandise for sale. Prices
for these goods may be included in this resolution.
1.3 Payment Due. Fees are due at the time the action is requested (e.g., at time of application)
or occurs (e.g., prior to a specific action). An applicant may pay all fees of a multi-phased
project in advance; however, doing so does not vest applicable fees due. Fees due are those
in effect at the time the specific action or phase of an action is requested or occurs.
1.4 Waivers. Upon petition by the applicant, the City Council may waive any of the fees, or
portions thereof, for any non-profit organization or government agency.
NOTE. State Surcharge Fees cannot be waived.
Permit Number: BLD-6143 Total Amount: $ 175.00
Staff Requesting Fee Waiver: Sarah Lopez Staff Department: Administration
Staff Email: slopez@arlingtonwa.gov Staff Phone #: 360-403-3448
Reason for Waiver: City project: Hispanic Heritage Event Tent operating permit fee
Council Workshop Date: 01/06/2025 Council Approval Date: 01/06/2025
Sarah Loll@Z Digitally signed by Sarah Lopez
Signatory Authority: N Date:2025.01.07 13:41:56-08'00'
Print Name: Sarah Lopez
CED STAFF USE ONLY
FEE BREAKDOWN
Plan Review Fee(s) $
Permit Fee(s) $ 150.00
Processing Technology Fee $ 25.00
State Surcharge Fee $
Other: $
Other: $ ACCEPTED BY DATE STAMP
REV5.2021 Page 1 of 1