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HomeMy WebLinkAbout18827 43RD DR NE_BLD20080004_2026 INSPECTION REPORT • Permit No.: C9-6M7 Lot #: Address: 7- L211 Contractor: si 1 r • Owner: Try sCc Date: "' 7--ei 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 435-0674 FOR RE-INSPECTION -24 hour notice required. 'r► v Inspector: Date: TYPE OF INSPECTION REQUESTED ❑ Under-floor ❑ Framing ❑ Ga Piping ❑ Footing ❑ Drywall, Nailing ❑ C sultation ❑ Foundation ❑ Shear Nailing ❑ G oundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in 11 Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: Zyio �. INSPECTION REPORT • Permit No.: 015 o g o y Lot#: .� Address: f d 8 2.1 41 0 YL_ Contractor: SiTv, w oy"c-s pv Owner: 4 A,.A s Date: 6-1-06 ❑ APPROVAL ❑ PARTIAL APPROVAL ❑ VIOLATION o LOORRECTION REQUESTED cS-corrections listed below MUST BE MADE before work can be approved. ❑ Please contact inspector. ❑ Was not able to perform inspection. ❑ CALL 435-0674 FOR RE-INSPECTION - 24 hour notice required. AA QvL2 O:•t C.r- PL s.R'l1'L7�7l �1 sJ L�Fh rt L / 5�`�� P ii s.J Z+"`(YL79T i�(1 ! A% h ✓-�'Yt.�'� �<_11 67 LNL /- ^j ��'ti�?>Z-1�5�� �! l N t45TYL rTtl ass:►g,.d LA PA c AL"d cs Grr.v ne•.��c . H,+�GYZ-C:t.t T �—✓��n,.;�'J t�t J e c�,/L M 1 �+ i �-YL- (�n L� J9 c',v,;`J —7 J IJ (�,r vt c,r� 7 dQ Rn 5 �)c-o,K ✓�N O�yL iJ�}�00:2 ( 4W&"e-2e- �KnV1 Oar L✓�-i.(!7f N -1 ITT �''11�i. 0�11L STt�S L;r IA G✓Ly41'_L. TD R C S u p p a r XV)0_ Inspector: Date: fg -/- Os 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 X Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: INSPECTION REPORT • Permit No.: o8-o oo y Lot#: Address: 1 a 8 Contractor: J •S �� • Owner: Date: E-APPROVAL ❑ PARTIAL APPROVAL Q VIOLATION ❑ CORRECTION REQUESTED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ Please contact inspector. ❑ Was not able to perform inspection. ❑ CALL 435-0674 FOR RE-INSPECTION - 24 hour notice required. Inspector: �� Date: TYPE OF INSPECTION REQUESTED ❑ Under-floor ❑ Framing ❑ Gas Piping ❑ Footing 14,Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: INSPECTION REPORT Permit No.: Lot #: Address: ? 4- Contractor: S�`�r �•olds • Owner: Date: 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 435-0674 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 0 Insulation ❑ Other: INSPECTION REPORT • Permit No.: 00—OC70 Lotr#: Address: /9� 7 " Contractor: S' Owner: Date: 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. ❑ SAL/� 35-0674 FOR RE-INSXEC-�T/ION -24 hour notice required. �l G� 421 3// Cl1 r CS.? i /n Inspector: /S/ Date: TYPE OF INSPECTION REQUESTED ❑ Under-floor ,Framing Pff Gas Piping ❑ Footing ❑ Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: INSPECTION REPORT • Permit No.: ©a '-600V Lot#: Contractor: • Owner: Date: ❑ APPROVAL G2i 'ARTIAL APPROVAL ❑ VIOLATION i13(60RRECTION REQUESTED ❑ Corrections listed below MUST BE MADE before work can be approved. ❑ Please contact inspector. ❑ Was not able to perform inspection. ❑ CALL 435-0674 FOR RE-INSPECTION -24 hour notice required. 2�G GI U✓�c�! Y� Inspector: Date: TYPE OF INSPECTION REQUESTED ❑ Under-floor ❑ Framing )4 Gas Piping ❑ Footing ❑ Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork .z4-Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: INSPECTION REPORT Permit No.: os c,,)oy Lot#: 3 Address: t'?8 2---1 3 ,p A- Contractor: S' • Owner: Date: 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 435-0674 FOR RE-INSPECTION -24 hour notice required. ITV Inspector: Date: fS 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 0 Other: 2L� INSPECTION REPORT • Permit No.: oS boos{ Lot#: Address: 199 z-) 141 0 vL- Contractor: S^t-x�s iz_c, Owner: Date: y-1 v-�� 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 435-0674 FOR RE-INSPECTION -24 hour notice required. Inspector: — Date: I a— 0� 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: INSPECTION REPORT Sys Permit No.: o6 -00oq Lot#: 3 Address: 18 S z., 4 3 17 yc- Contractor: x-o Owner: Date: 3-2-7- a I 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 435-0674 FOR RE-INSPECTION - 24 hour notice required. .D;.. �.ra-ram ,� •� r� n-L.� �3='�-w��� L4 Inspector: Date: 3-�7- J" TYPE OF INSPECTION REQUESTED ❑ Under-floor ❑ Framing ❑ Gas Piping ❑ Footing A Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: INSPECTION REPORT • Permit No.:(f)8 C.r?3 Lot#: Address: lggi9q ? '-#3 ,dr Contractor: 3ene-5 ca • ♦ Owner: Date: 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 435-0674 FOR RE-INSPECTION - 24 hour notice required. Inspector: Date: _I r TYPE OF INSPECTION REQUESTED 9§-4)nder-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: 330 INSPECTION REPORT • Permit No.: ©g3 oo;a 4 Lot#: 2— Address: -1 ga z:j 44 3," o w-- Contractor: 5.-,..,,s Owner: Date: XC3APPROVAL ❑ PARTIAL APPROVAL _VIOLATION RRECTION REQUESTED orrections listed below MUST BE MADE before work can be approved. ❑ Please contact inspector. ❑ Was not able to perform inspection. ❑ CALL 435-0674 FOR RE-INSPECTION - 24 hour notice required. -Z-->4'0-1'-j s Awr��-rn Inspector: Date: -S�s 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: ,N INSPECTION REPORT • Permit No.: O"3 oa cry Lot #: Address: t P.t3 2--7 y 3 Contractor: .r Owner: Date: 2--Z-)-o tf. O 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 435-0674 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 El Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation 0 Other: /O Ov Poll- NSPECTION REPORT • Permit No.: o S o ool-f Lot#: 3 Address: /fR$ Z--7 Ll 3 �J,2. Contractor: A W1 s 14 o • Owner: Date: z- Z o d,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 435-0674 FOR RE-INSPECTION -24 hour notice required. 77 Inspector: Date: .Z-- 21 ---A& TYPE OF INSPECTION REQUESTED ❑ Under-floor ❑ Framing ❑ Gas Piping 9 Footing ❑ Drywall, Nailing ❑ Consultation ❑ Foundation ❑ Shear Nailing ❑ Groundwork ❑ Mechanical ❑ Grid ❑ Struct. Slab ❑ Wood Stove ❑ Rough-in ❑ Final ❑ Masonry ❑ Drainage ❑ Insulation ❑ Other: " CITY OF ARLINGTON 238 N.OLYMPIC AVE.-ARLINGTON,WA.98223 PHONE:(360)403-3421 Permit#: BLD20080004 BUILDING PERMIT Project :address: 18827 43RD DR NE, ARLINGTON Parcel No: PROPERTN'OWNER APPLICANT CONTRACTOR JANISKO JANISKO SITEWORKS INC 10119 8 I ST AVE NE 10119 81 ST AVE NE 30808 247TH AVE NE MARYSIVLLE,WA 98270 MARYSIVLLE,WA 98270 ARLINGTON,WA 98223 Phone:425 346-7559 Phone:425 346-7559 LICENSE#:SITEWIx027R8 EXP:2/27/2008 Email: Email: PLtJMBING CONTRACTOR MECHANICAL CONTRACTOR Lie#: Ex : Uc#. Ex : DESCRIPTIONJOB DUPLEX UNIT-2 STORY EACH UNIT IS: 1ST FLR-909 SQ.FT,2ND FLR-893,GARAGE 438 SQ.FT. R3-VB LOT 3 of Janisko Short Plat. VALUATION: $379,105 PERMIT TYPE:Residential JEERMIT GROUP:Duplex NUMBER OF STORIES:0 ITYPE OF CONSTRUCTION: NUMBER OF DWELLING UNITS:0 1 OCCUPANT GROUP: CODE:2006 OCCUPANT LOAD: BASEMENT:0 1ST FLOOR:0 2ND FLOOR:0 BASEMENT:0 1 ST FLOOR:909 2ND FLOOR:893 3RD FLOOR:0 GARAGE:0 DECK:0 OTHER:0 13RD FLOOR:0 GARAGE:438 DECK:60 OTHER:0 FRONTSETBACK SIDE SETBACK REARSETBACK REQUIRED: PROPOSED: REOUIRED: PROPOSED: REOUIRED: PROPOSED: HEIGHT ALLOWED:0 PROPOSED:O REQUIRED: PROPOSED: SETBACK NOTES: PERMITAPPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY,NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. �}a!�r s o f �Z 0k 4gad--ASig ure Print Name Date Release ate ATTENTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED.UBC109/IBC 110/IRC110. ARCHIVE APPLICANT = ASSESSOR OTHER BLD20080004 CONDITIONS • Lot line stakes must be in place at the time of foundation/setback inspection. • Installation,use and maintenance of equipment and components shall be per manufacturer's specifications, installation instructions,and applicable state codes. Provide manufacture's installation instructions on site for Building Inspector. • Approval of this foundation design is conditional subject to inspection of existing site soil conditions. Retaining Walls must be designed and constructed to resist the lateral pressure of the retained material. Provisions must be made for the control and drainage of surface water around buildings. • Installer shall provide the manufacturer's installation,operating instructions,and a whole house ventilation system operation description.A label shall be affixed to the whole house timer control that reads "Whole House Ventilation"(see operating instructions). • Hose Bibbs(exterior faucets)are required to have a permanently affixed anti-siphon device installed. • In addition to the required pressure/relief valve,an approved listed expansion tank shall be installed on all hot water tanks. Per UPC 608. • Type B or L vent connectors required on fuel-burning appliances passing through unheated spaces.Per IMC 803.2 • Obtain Electrical Permit from State Department of Labor&Industries. • Pursuant to UPC 605.2 a water service shutoff shall be installed on the water line as it enters the building. • City approved plastic piping may be used in water service piping provided that where metal water service piping is used for electrical grounding purposes,replacement piping shall be of like materials(UPC 604.8).A state electrical permit and inspection is required if electrical grounding is altered,removed,improved,or added.Contact State Dept.of Labor& Industries Electrical Division at 425-290-1309. • Final approval on a project or final occupancy approval must be granted by the Building Official prior to use or occupancy of the building or structure.Check the job card for all required City inspections including final project approval and final occupancy inspections. • Provide combustion air per IMC for commercial and multi-family residential installations,and IRC for one and two-family dwellings. • A pressure regulator valve(PRV)shall be installed near the water shutoff. • New and existing buildings shall have approved address numbers,building numbers or approved building identification placed in a position that is plainly visible from the street or road fronting the property. Address numbers shall be Arabic numerals or alphabet letters. Numbers shall be legible from the public way,at least 4 inches high with a%inch min. stroke width on a contrasting background. • Pre-sales or"model showing of units"is defined as a"use"of a building or premises and is inherently hazardous to the public prior to issuance of a certificate of occupancy. Pre-sales or model showing shall not be allowed without a(permanent or temporary)certificate of occupancy. Emergency plans as outlined by IFC Chapters 4 or 14 and local safety standards must be met for approval of temporary certificate. No building or structure shall be used or occupied until that certificate of occupancy,or temporary certificate is issued. • Call for locates of underground utilities 2 business days prior to any excavation. 1-800-424-5555 • Call for required inspections as noted and prior to backfill. PERMIT FEES Description _�,i[:�: 11r `ram �Pafi ._:' Si131�'e:BnC C-Building Permit Fee $3,063.50 $0.00 $3,063.50 C-Plumbing Permit Fee $309.00 $0.00 $309.00 C-Mechanical Permit Fee $209.00 $0.00 $209.00 C-Building Plan Review Fee $1,200.00 ($1,200.00) $0.00 PLNCK 1991.97-1200.00=791.97 $791.97 $0.00 $791.97 C-State Building Code Surcharge $4.50 $0.00 $4.50 DUPLEX UNIT-State surcharge $2.00 $0.00 $2.00 Total Due: $5,579.97 ($1,200.00) $4,379.97 INSPECTIONS THIS PERMIT AUTHORIZES ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY.ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION. i i CALL FOR INSI'ECTIONS BUILDING/ENGINEERING/PARKS/UTILITIES/FINAL(360)435-0674 FIRE(360)403-3607 When calling for an inspection please leave the following information: Permit Number,Job Site Address,Type of Inspection being requested,Contact Name and Phone Number,Date Prefereed,and whether you prefer morning or afternoon. • C-Footings • C-Foundation Wall • C-Foundation Drainage • C-Plumb Ground Work • C-Plumb Rough In • C-Gas Test/Pipe • C-Equipment-Mechanical • C-Shear Nailing-Exterior • C-Framing • C-Wall Insulation/Caulk • C-Building Final • C-Underfloor • C-Gas Piping Groundwork ti ti ONCG;`S SI' 'GLE FAMILY RES 'DENCE BUILDING PERMIT APPLICATION Department of Community Development City of Arlington - 238 N Olympic Ave. • Arlington, WA 98223 - Phone (360)403 3431 • FAX (360)403 3447 THIS APPLICATION TO BE USED FOR ONE AND TWO DWELLING UNITS RESIDENTIAL STRUCTURES. THIS APPLICATION MUST BE ACCOMPANIED BY TWO (2) SETS OF CONSTRUCTION DRAWINGS, SIX(6)ACCURATE, FULLY DIMENSIONED PLOT PLANS AND TWO(2) SETS OF ENERGY CODE APPLICATIONS. TYPE OF PERMIT: ( Building ( ) Mechanical ( ) Plumbing ( ) Combination Project Address: ll_ 1 q;Izn Dc Parcel ID#: Lot#: -3 Subdivision: J PN'sK0 s Now P IA-T 8�.0©7 Project Description: LAP kX Owner: fTal.l`6Y1 JR1�1tsKD Phone Number: �z5- 3u�� 7'ssq Address: 10119 8157Avt n1F City: State wR Zip Code. IWO Contact Person: 1�Q n or Sx112 �afe5 ����Q. WC>s� Phon Number: yZS- 3y&- ?55q- 66t�am GUYL�o/Gt � • WL5- .S ylotl Cell Phone: Fax: — E-mail: Address: 10/11 21 s Ave NC" City:�h?�� "���!mac , State: Zip Code: L ? 7�2 o Lending Agency: 460701_�P Sa y;h4s — Pe4t Edoc-comb Phone Number: 425- 75y' 1300 Address: City: State: Zip Code: 1 Contractor: � A.0 OT(S Phone Number: Address: City: State: Zip Code: Contractor's License Number: Expiration: Plumbing Contractor- Phone Number: Address: City: State: Zip Code: Contractor's License Number: Expiration: Mechanical Contractor: Phone Number: Address: City: State: Zip Code: Contractor's License Number: Expiration: FOR STAFF USE ONLY JAN _ 4 2008 Lf ) BY: Permit# Accepted By Amount Received Receipt# Date Received WEB Forms-46 Page 1 of 2 5/05 dwa T C,`�Y SIC _ GLE FAMILY RES' )ENCE o JBUILDING PERMIT APPLICATION f N G� Department of Community Development City of Arlington • 238 N Olympic Ave. •Arlington,WA 98223 • Phone(360)403 3431 • FAX (360)403 3447 Number of Plumbing Fixtures (Including Rough-Ins) Accessory Main Total Fixture Total Number Fixtures Plumbing Fixtures Dwelling Unit Residence Unit#X Units Multiplier Bar Sink — X 1.0 = Bathtub or Combination Bath/Shower z X 4.0 = Clotheswasher Z X 4.0 = 8 Dishwasher Z X 1.5 = 3 Hose Bibb X 2 5 = �p Kitchen Sink Z X 1 5 = 3 Laundry Sink — X 2 0 = Lavatory(Bathroom Sink) X 1 0 = �P Shower(Stand Alone) Each Head Z X 2.0 = �/ Water Closet(Toilet) G X 2.5 = 5 Whirlpool Bath or Combination — X 4 0 = «� Bath/Shower Water Heater 2 Z Other Total Fixture Units Traps (other than above items) Column Totals a Estimated Project Valuation 2a �dfJ Building Square Footage INRO 1st Floor 2nd Floor /786 3rd Floor — Basement — Deck _ Garage 8 7(a Water Supply Piping A. Fixture Units: Number of Fixtures X Fixture Units =Total Fixture Units B. Distance from meter to most remote outlet: 8G feet. C. Difference in elevation between meter and highest fixture: feet above meter or feet below meter. D. Pressure in street main: to psi. (Measure with gauge or check with Water Department) I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the above- described property wil a in accordance with the laws, rules and regulation of the State of Washington. A-A 17v"\ �Z aa Lo8 icants Signature Date FOR STAFF USE ONLY Permit# Accepted By Amount Received Receipt# Date Received WEB Forms-46 Page 2 of 2 5/05 dwa i I I I �K I� Y i ll. �16 1 Prescriptive Energy Code Compliance for Single Family and Duplex Housing: Zone 1 P!o;ect Information Contact Information This set of forms has been developed to assist permit applicants documenting compliance with the Washington State Energy Code, (2006 edition). This set is for type R-3 and R-4 structures located in climate zone 1. The following forms provide much of the required documentation for plan review. The details noted here must also be shown on the drawings (WSEC 104.2). This form is not a substitute for the energy code itself. To obtain a copy of the energy or ventilation codes, go to the following web address. http://www.energy.wsu.edu/code/code2006.cfm Option Glazing Glazing U-Factor Door 9 Ceiling Vaulted Wall'" Wall- into Wall-ext4 Floors Slab on Area 10: % U-Factor Ceiling' Above Below Below Grade of Floor Vertical Overhead)1 Grade Grade Grade ❑ I I0'% 0.32 0.58 0.20 R-38 R-30 R15 R-I5 R-10 R-30 R-10 Unlimited 0.35 0.58 0.20 R-38 R-30 R-21 R-21 R-10 R-30 R-10 Group R-3 ❑Iv. and R-4 Occupancie L_ s Only See WSEC table 6-1 for footnotes Glazing Schedule Attached to Document ❑ Does not apply. Using Prescriptive Option IV. All glazing and doors meet maximum U-factor. Using Prescriptive Option IV. All glazing and doors meet maximum U-factor. All glazing and doors meet maximum U-factor. Alternate heating size method submitted ❑ Option I, Glazing to floor area limit(WSEC 602.7.2) ❑ Area weighted window, skylight or door U-factor(WSEC 602.7.2) ❑ As part of the heating and cooling system sizing calculation (IRC M1401.3 &WSEC 503.2.2) Radiant slab: ❑ R-10 foam insulation, continuous with thermal break (WSEC 502.1.4.9) WSEC Prescriptive Worksheet(2006 edition)Zone 1 R-3 or R-4 Insulation WSUEEP07-010 Copyright 2007 • ; * . r• 4� 1 t �i co °� City of Arlington • Public Works Utilities Division '�, �o Water Department ph. 360.403.3526 LNG CROSS CONNECTION SURVEY Residential FOR OFFICE USE ONLY Date Received: Survey reviewed by: Survey accepted by: Assembly Required: ❑ No ❑Yes DCVA RPBA Inspection Type of Residence: ❑ Single Family 0 Duplex ❑ Triplex ❑ Apartment # of Units ❑ Other Project Site Address: l�r NF gr•�iriQ-�h Property Tax ID#: Lot#: 3 _ Building Permit #: Subdivision: J A,-S,%S I. -She zr Building size: 0, # of stories Project description: JJetj CPNskiae4 en LlpleX Property Owner: 46Vbrx aA-\4,c1-0 Property Owner's mailing address: 10119 S s- Xy a .NK ''\ar-yS0 i lit , W j- 99270 Property Owner's Phone# u2-5- 3i°l(D" ?SS 9 Fax# Occupant/Contact's name: A-H-ePtna.'le_. GQA*x S �iP a'�S S�4eworr-f 1 JJ(-) Occupant/Contact's mailing Address: Occupant/Contact's Phone # t4Z5,- 32.7- y100 Fax# The Rules and Regulations of the State of Washington Department of Health require that certain premises install backflow prevention assemblies.(WAC 246.290.490). Backflow prevention assemblies shall be installed at any premise where,in the judgement of the City of Arlington Cross Connection Control Specialist,the nature of activities on the premise may present a hazard to the public water system, should a cross connection exist. CCS Residential pg 1 2006 i • •', ., ��� • � Y ���T - 1 i�i /: _ 1 ��, • , .,J 7 1: .. _ 1 I F City of Artinaton Utilities Division Cross Connect., n Survey Property Site Address: IV DCj q3r Dr �Jf. 1411na n WA 192Z3 Name of person filling out survey (please print): Itpo✓1 �1�1<V1 Place a check mark next to all equipment/fixtures listed below that are, or will be, permanently or occasionally connected to water for use at your residence (single family, multi-family, mobile,etc.) Toilets ❑ Shampoo Basin ,i�(' Sinks (kitchen, bathroom, etc.) ❑ Drinking Fountains ❑ Janitor sink ❑ Film Processors Hose Bib (outside faucet) ❑ Photo Developing Sinks/Tanks etc. �( Bath tub ❑ Solar Heating system Shower ❑ Heating system using water Dishwasher ❑ Heating Boilers ❑ Garbage disposal ❑ Boiler Feed Lines ❑ Ice maker ❑ Bidets ;4 Clothes Washer ❑ Dialysis Equipment ❑ Air Conditioner ❑ Medical Equipment ❑ Fire Sprinkler system ❑ Water Treatment/Filtration System ❑ Lawn Sprinkler system ❑ Decorative pond/fountain ❑ Private Well on property ❑ Hot tub ❑ Swimming pool The above information is complete and accurate to the best_ my knowledge. I understand that any changes in equipment connected to the domestic water system must be reported immediately to the City of Arlington Utilities Division as a condition of continued service. 4aAyn Sig ture \ �fy11 .JQYIaS�D Print name , 1210� Date CC Residential pg2 2006 � - . I r {` t Jj •i 00 '7 n g .n - ;tn g3 ggpq4�� ���a e. Ilk W � W r o HER O Y O In Jill 02 Tlu K W g U. 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