HomeMy WebLinkAbout18204 59th DR NE Unit A_972317_2026 1
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C I YY OF ARl__. I NSYON
COh1S;TRUC7 I ON PERM I T
FRERh9I Y NO- 0 97-23I7
Owner: CLARK, SHIRLEY 13-0 N S'TILLAGUAMISH AVE ARLINGTON 98223
Value of Work: $2, 0W. 00 Tax ID: 448E-17-36 Phone: 4315-2548
Describe Work: INSTALL PORTABLE EXPRESSO STAND
Proposed Use: EXIDRESSO STAND PERMIT EXPIRES IN E YEARS FROM DATE OF ISSUE
Legal Description:
Job Address: 18204 59TH DR
Contractor' s Name Type Address License#
H
TOTALS Fee
Permit Fee $67. 75
State fee $4.50
SI6NALURE�
TOTAL FEE. .. . .... . . . . . .. . . $72.25 1 HAVE READ
AND EXAMINED THIS APPLICATION AND
PAYMENTS. . . . . . . . . . . . . . . . . . $0.0 KNOW THE SAME TO BE TRUE AND COR-
RECT ALL PROVISIONS OF LAWS AND
TOTAL DUE. ... . . . . . . . . ... . $72.25 OR LES GOVERNING THIS TYPE: OF
vJUt� WI L BE COMPLI i.j I T H ;HL T HER
FDATE
SP I F ED HE" 1- J - T # j0aI15
HU LDING OFFICIAL
Memorandum
City of Arlington
Department of Community Development
Building Department
Date: 14— —�/?
To:
1� ')-0 � 5-r77f
From: A of Arlington Building Department
Subject: Expired Building Permit
No work has commenced within 180 days of the date of the last inspection, as per UBC
Sec. 106.4.4 "Expiration".
Therefore this file is being closed as an expired permit.
Building Permit file no: ` 9317
e, 1
Last Inspection Date: T�
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Building Official
building\memolclosed
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CITY OF ARLINGTON
CONSTRUCTION
PERMIT
❑ COMBINATION BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO. �
WNER MAIL ADDRESS CITY ZIP PHONE
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ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE
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GENE AL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LIC NSE N
O er ll 13 v2 VIAK N E 5 0713 cc z
MEC '"✓jDF4TVCTOR MAIL G/C�.� ►�lC. ! /AOORESS CITY,OQ'h� C•�i' JNV •zip
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ANICAL
PA,WMMG CONTRACTOR MAIL ADDRESS J ` CITY ZIP PHONb��� LICENSE
C S5 OF WORK �( [ 9
O NLW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLI TION BUILDING RELOCATION
LUATIONOF WORK
Z
W SCRIBE WORK
L v �ULJ 1tQ oln JL QLA. — "f � n� i /9 r 1 e
m P PUSS D USE Of BUIL ING
'I ( c I HEREBY CE TIFY THAT I HAVE READ AND EXA INED THIS APPLICA-
w J ' '1 L`e �-Z/!� ' TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI-
J LLGAL U SCRIPTION Of PROPERTY(SHOWN BELOW OR ATTACH )UR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK
J )1 BLOCK - OF WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE
GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO
— VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR
�JI XID NUMBER FROM PROPERTY TAX STATEMENT LOCAL LAW REGULATING CONSTRUCTION OFTHE PERFORMANCE OF
X IAN U M B E R FROM PROPERTY TAX STATEMENT
a. CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE.
O SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE
U OB UURLSS Cl1 S`� J I ' c E 19'I 2_Z3 X
(OFFICE USE ONLY)
PLUMBING MBOIANICAL
NO. TYPE OF FIXTURE FEE a's FIXTURES NO. TYPE OF EQUIPMENT FEE s's FIXTURES
HATER CLOSET(TOILET) IR COND.UNITS—H.P. EA. 7 tip.list**
3ATHTUB 1EFR1GERATION UNITS—H.P.EA 3wip.list—
AVATORY(WASH BASIN) 301LERS—H.P.EA. ?pup.list••
'HOWER AS FIRED A.C.UNITS—TONNAGEEA. 30df).list**
TCHEN SINK&DISPOSAL _ 'ORCED AIR SYSTEMS—B.T.U. MEA
)ISHWASHER NALL 11EATERS—B.T.U. M
AUNDRY TRAY JN IT HEATERS—B.T.U. M
.LOTH ES WASHER WAPORATIVE COOLERS
ATER HEATER _LOTHES DRYERS
JRINAL _ VENTILATION FAN
)RINKING FOUNTAIN LANGE HOOD COMMERCIAL
7LOOR DRAIN kIR HANDLING UNIT— CPM
ACUUM BREAKERS iTOVE
1OOF DRAINS—RAINLEADERS AETAL FIREPLACE&CHIMNEY
SINK(SERVICE—BAR,ETC.) WATER HEATER
3AS PIPING •(uo to 5=$3.00.addol.=S.7_5_ •_
•Equipment list must be provided
SUB TOTAL SUB TOTAL
PERMIT PERMIT
TOTAL FEE TOTAL FEE
SIUL YARD SL I BACK STRELI SL T BACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE
FEE RECEIPT NO.
USE/ONI LOT ARF A VACANT SITE
❑YES ❑NO FEES VALUATION FEE
I'YPL OF CONST OCCUPANCY GROUP NO.OF DWELLING UNITS PLAN CHECKING NG
SILL Of BLDG. NO.Of STURILS MAX.00C.LOAD BUTDING $
PLUMBING
F IRE SPRINKLERS REQUIRED
❑YES ❑NO MECHANICAL
COMMENTS STATE BLDG.CODE
ENERGY CODE SURCHARGE
PENALTY U.B.C.
SEC.303(a)
WATER/SEWER FEES
TOTAL
PERMIT VALIDATION
WHEN PROPERLY VALIDATED (IN THIS SPACE)THIS IS YOUR PERMIT&RECEIPT
PAID CR# BY
cc: ASSESSOR,APPLICANT,TREASURER, BLDG. DEPT BUILDING OFFICIAL DATE
RECORDS COPY