HomeMy WebLinkAbout19907 51ST DR NE_983314_2026 INSPECTION_REPORT
Permit No. Lot
• Address t O-7
s
Contractor
Owner �K<- ? C
Date ]/^ .5-' ! 5z
,a APPROVAL ❑ PARTIAL APPROVAL
❑ VIOLATION ❑ CORRECTION REQUESTED
❑ Corrections listed below MUST BE MADE before work can be approved.
❑ Please contact inspector.
❑ Was not able to perform inspection.
❑ CALL 435-0724 FOR RE-INSPECTION - 24 hour notice required.
Inspe Date
TY E 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
❑ OtherC����/1�
LL I
CITY OF ARLINOTON
CON0-r RLJCT I ON RE RM I T
AERMIT CVO- a SO—aZ1-e+
Owner: CLARK DICKSON 19907 51ST DR. NE ARLINGTON 98223
Value of Mork: $29000. 00 Tax ID: 4264-000-024-0005 Phone: 435-4374
Describe Mork: CONVERT TO GAS
Proposed Use: SFR
Legal Description:
Job Address: 19907 51st DR NE
Contractor;s Name Type Address License#
DICKSON CLARK OWN 19907 51ST Did
_ -- R - E R M! I T F E E S
Equipment andFixtures - Number --Fee Total Charge
- - _
1 $10.65
DRYER $10.85
METAL FIREPLACE & CHIMNEY 1 $10.65 $10.65
} WATER HEATER 1 $10.65 $10.65
S U B T O T A L...... $31.95
TOTALS Fee
Equipment $.31.95
Mech Permit $L3.50
SIGNATURE•
'TOTAL FEE........ $55.45 I HEREBY CERTIFY THAT I HAVE READ
AND EXAMINED THIS APPLICATION AND
PAYMENTS..................30.0 KNOW THE SAME TO BE TRUE AND COR-
RECT ALL PROVISIONS OF LAWS AND
DU_ . . . $55.45 ORDINANCES U�4ERNING .'IIS TYPE OF
WORK WILL BE '] iI- WITH WHETHER
^n n SPEC I F , ^ NOT,
CITY OF ARLINGTON
CONSTRUCTION
PERMIT
❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN PERMIT NO. �
OWNER L MAIL ADDRESS CITY ZIP PHONE
,'�rC1�Sa �2 Cla-rk . 1'996 7 9E�204
ARCHITECT OR DESIGNER MAIL ADDRESS Cl TY ZIP PHONE
GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N
MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N
PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE N
3 CLASS OF WORK
0[aNLW ❑AUDITION ALTERATION REPAIR ❑UEMULI]ION ❑BUILDING RELOCATION
CC VALUAI ION OF WORK
Z s �o� T Pi ✓ice CJi1E' i 7? ��/� �'
W DESCRIBE WORK
3
I—
m PROFUSE D USE Of BUILDING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA-
TION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVI-
Z LLGAL UESCRIPI ION UI PROPERTY(SHOWN BEt OW OR AT]ALH FOUR COPIES) SIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK
J
J LUI BLOCK • OF WILL BE COMPLIED WITH WHETHER SPECIFIED HERIN OR NOT.THE
a GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITYTO
w o0O VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR
u~I LOCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF
J TAX ID NUMBER FROM PROPERTY TAX STATEMENT
IL CONSTRUCTION. PERMIT EXPIRES 1 YEAR FROM DATE OF ISSUANCE.
L? 5-1 Sr, SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT DATE
V108 ADDRI SS
r X
(OFricE USr ONLY)
PLUMBING MECHANICAL
NO. TYPE OF FIXTURE FEE n's FIXTURES NO. TYPE OF EQUIPMENT FEE ='s FIXTURES
WATER CLOSET TOILET) lR COND.UN ITS—H.P. EA. Icitip.list—
IATHTUB UTRTGERATION UNITS—H.P.EA u _list—
.AVATORY ASH BASIN OILERS—H.P.EA. 3qtip.list—
ROWER jAS FIRED A.C.UNITS—TONNAGE EA. 3qWp.list—
TCHEN SINK&DISPOSAL ORCED AIR SYSTEMS—B.T.U. MEA
ISHWASHER JNALL HEATERS—B.T.U. M
UNDRY TRAY NIT HEATERS—B.T.U. M
LOTHES WASHER IVAPORATIVECOOLEPS
WATER HEATER LOTHES DRYERS
RINAL VENTILATION FAN
)KINKING FOUNTAIN tANGH HOOD COMMERCIAL
LOOK DRAIN IR HANDLING UNIT— CPM
VACUUM BREAKERS FrOVE
tOOF DRAINS—RAINLEADERS ImLrAL FIREPLACE&CHIMNEY
INK(SERVICE.—BAR.ETC-) WATER HEATER
AS PIPING *Cup to 5=$3.00.addnl.=$35
ui ment list must be rovided
SUB TOTAL 9 SUB TOTAL
PERMIT 9 PERMIT
TOTAL FEE 9 TOTAL FEE
SIDL YARD SL[BACK SFRLLI SL TBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE
FEE RECEIPT NO.
LSk /ONf LOT ARI A VACANT SITE
FEES VALUATION FEE
❑YES ONO
TYPE OF CONS] OCCUPANCY GROUP NO.OF DWELLING UNITS PLAN CHECKING NG
BUTDING f
SIZE Of BLDG NO.Of STORILS MAX.OCC-LOAD
PLUMBING
FIRE SPRINKLERS REQUIRED
❑YES ❑NO MECHANICAL
COMMENTS STATE BLDG.CODE
ENERGY CODE SURCHARGE
PENALTY U.B.C.
SEC.303(a)
RECEIVED WATER/SEWER FEES
�• TOTAL
PERMIT VALIDATION
WHEN PROPERLY VALIDATED (IN THIS SPACE)THIS 15 YOUR PERMIT&RECEIPT
PAID CRR BY
cc: ASSESSOR,APPLICANT.TREASURER, BLDG,DEPT. BUILDING OFFICIAL DATE
RECORDS COPY