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HomeMy WebLinkAbout17700 67TH AVE NE_BLD20090105_2026 CITY OF ARLINNGTON 238 N.OLYMPIC AVE.-ARLINGTON,WA.98223 PHONE:(360)403-3421 Permit#: BLD20090105 BUILDING Project Address: 17700 67TH AVE, ARLINGTON Parcel No: 31052200400500 PROPERTV OWNER APPLICANT CONTRACTOR Miller,Brandon Miller,Brandon MTA Construction,Inc 17700 67TH AVE NE 17700 67TH AVE NE 17700 67TH AVE NE ARLINGTON,WA 98223- ARLINGTON,WA 98223- ARLINGTON,WA 98223- Phone:( ) - Ext. Phone:( ) - Ext. LICENSE#:MTACOI*150NH EXP: Email: Email: PLUMBING CONTRACTOR MECIIANICAL CONTRACTOR Lic#: I c Lick Ex JOB DESCRIPTION Demolish the house and the garage VALUATION: $0 PERMIT TYPE:Residential IPERMIT GROUP:Demolition NUMBER OF STORIES:0 1 TYPE OF CONSTRUCTION: NUMBER OF DWELLING UNITS:0 OCCUPANT GROUP: CODE:2006 OCCUPANT LOAD: BASEMENT:0 1 ST FLOOR:0 2ND FLOOR:0 BASEMENT:0 1 ST FLOOR:0 2ND FLOOR:0 3RD FLOOR:0 GARAGE:0 DECK:0 OTHER:0 13RD FLOOR:0 GARAGE:0 DECK:0 OTHER:0 FRONTSETBACK SIDE SETBACKSETBACK REQUIRED: PROPOSED: REQUIRED: PROPOSED: RE UIRED: PROPOSED: HEIGHT ALLOWED:O PROPOSED:O RE UIRED: PROPOSED: SETBACK NOTES: PERMIT APPROVAL 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 Signature Print Name Date Re ased By 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/IBC110/IRC110. ARCHIVE APPLICANT ASSESSOR OTHER 1 BLD20090105 CONDITIONS • Wells must be decommissioned according to Dept.of Ecology standards,including WAC 173-160-381,per AMC 13.32.100. Provide proof of decomissioning to City of Arlington Utilities Division. PERMIT FEES Date Description Fee Amount Paid Balance Due 5/20/2009 C-BUILDING PERMIT FEE $100.00 $0.00 $100.00 5/20/2009 C-STATE BUILDING CODE SURCHARGE $4.50 $0.00 $4.50 Total Due: $104.50 $0.00 $104.50 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. CALL 1 ' INSPECTIONS 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. • None DEMOLITION PERMIT APPLICATION _ Department of Community Development City of Arlington • 238 N Olympic Ave. •Arlington, WA 98223 • Phone (360)403 3551 • FAX (360)403 3447 THIS APPLICATION MUST BE ACCOMPANIED TWO(2)SETS OF FULLY DIMENISIONED PLOT PLANS AND SITE CLEAN-UP PLAN, TWO(2) COPIES OF AN ASBESTOS ABATEMENT REPORT COMPLETED BY AN APPROVED AGENCY. Type of Permit: (check one) (Residential rVol Commercial Project Address: -7-4� (01-11 Pi- , Parcel ID#: 31c5,r),aod 1mSc,->c> Lot#: Subdivision: Valuation: Building Area (Sq Ft) 2-1(3C.-) No. of floors: 2 Number of Buildings: 2 Owner: FX3ar 3on M(I I.' Phone Number: Hz5__ 1350 Address: Z� 1 0, "}• City: 1'�`1,-� State: 08 , Zip Code: 98ZZ3 Contact Person: gfrrrdcn Phone Number: 42-5- �''70 '79:55- Cell Phone: Fax:3W y31;- (31;7& E-mail: SmnAelk C.., Lux�nicurnr _� Address: City: A-rl f�l State: t. I , Zip Code: °r laZ2 3 _ Scope of Work: i Contractor: Phone Number: 3LCQ_Nxs Address: City: State: Zip Code: yx Contractor's License Number: )Ln:K C 2 Expiration: 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 will be in accordance with the laws, rules and regulations of the Stat of Washington. r� 5 � Applicants Signature Date ® 1 - �� T7_f_�rtc�!.n h�i I Kam' �d o� Print Applicants Name cOApF 2 0200 rcFN kb FOR STAFF USE ONLY Q3- Permit# Accep d By Amount Received Receipt# Date Received WEB Forms—125 Page 1 of 1 4/08 sb CERTIFICATE OF COMPLETION Affordable Abatement, Inc. 3616 Colby Ave#701 Everett, WA 98201 05-04-2009 Asbestos Removal was performed at the following address: 100 VAT& Mastic, 30 Sheet Vinyl& 300 Roofing Solid Rock Creations LLC 17700 67'"Ave NE Arlington, WA 98223 Be assured that all activities performed were conducted in accordance with all currently applicable environmental regulations and contract specifications. Any air monitoring required by statutes was performed. Clearance air sampling verified air was clean by current state and national standards. Regulated waste was deposited in accordance with EPA guidelines. An approved landfill facility is required to forward documentation of this within 45 days of disposal. Asbestos liability insurance and a contractor's surety bond was in effect during these operations. Please feel free to contact our customer service representative at (425) 303-8072 between 8:00 AM and 5:00 PM Monday through Friday if you have any further questions or need additional documentation. Sincerely, Louise Schroeder � OFFICL COPY 5/12/2009 CITY OF ARLINGTO%StatE Contractors License#: AFFORAi106CF :UILDING DEnARTMENTWA.State sbestos Contractor Certification. #: 1079 0" �. ,p• r) DATE ONLESS BY NGES AUTHORIZED APPROVED BY TH BUILDING INSPECTO ri��ruvcu irauSa�tlun rage 1 oI 1 piscleanalr.org Puget Sound Clear:1Vr Agency Single-Family Notification Case #: 200900972 This page must be Printed.A printout of the notification,all amendments to the notification, and the asbestos survey shall be available for Inspection at all tines at the asbestos project or demolition site(Reg III,4.03(a)(6)). Fee Amount Paid $75.00 Credit Card Transaction #VSHF3DOC9EE2 Transaction Date 05/16/09 Owner's Name Brandon Miller Phone (425) 330 2935 Street Address 17700 67th Ave City Arlington Zip 98229 Contact Person Brandon Phone (425) 330 2935 Mailing Address 231 W Jensen St Arlington,WA 98223 This project includes a demolition. Demolition Start Date 05/26/09 Completion Date 05/30/09 Demolition will be completed by the home owner I certify that: (1)This Is a single-family residence project.The structure Is used by one family who owns the property as their domicile. (2)The information I have provided is to the best of my knowledge accurate and complete. (3)I understand the fee for this Notification is nonrefundable. Create Another N Iflcation If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058. https:Hsecure.pscleanair.org/Asbestos/Approved.aspx 5/16/2009 WATER WE 1! CURRENT Original& I"copy-Ecolo "tpy-owner,3a copy-dril rl� Notice ofInteitNo. t c o t o c r dj� 2 8 100J Unique Ecology Well ID Tag No. f'! m Construct ion/Decomission ("x"in ci O Construction Water Right Permit No. r� Decommission ORIGINAL INSTA4ymigi + iQjQ j- Property Owner Name of Intent Number T Well Stre t Address PROPOSED USE: jrDomestic ❑ Industrial ❑ Municipal city r✓!' CP^-z COUnty ❑ DeWater Irrigation ❑ Test Well ❑ Other EwM Location 4-I%4 1/4 Sec wn �t .E crrte TYPE OF WORK: Owner's number of well(if more than one) WWM one ❑ New well ❑ Reconditioned Method Qtug ❑ Bored ❑ Driven Lat/Long t r Lat Deg_ Lat Min/Sec ❑ Deepened -13 Cable ❑ Rotary ❑ a on Jetted gS> > DIMENSIONS: Diameterofwell inches tied ft. Still REQUIRED) Long Deg Long Min/See Depth ofcompletcd well 1' ft ,-� ] f'� CONSTRUCTION DETAILS Tax Parcel No. S l `� 5- /�2 2 v k--^Y +� Casing ❑ Welded Diam.from ft.to ft. Installed: I.mer installed — Diam.from ft.to ft. CONSTRUCTION OR DECOMMISSION PROCEDURE Thicadcd Diam.from ft.to ft. Perforations: 0 Yes No'� Formation: Describe by color,character,size of material and structure,and the kind and nature of the material in each stratum penetrated,with at least one entry for each change of Type of perforator used information. (USE ADDITIONAL SHEETS IF NECESSARY. SIZE of perfs in by in.and no of perfsfrom ft to ft MATERIAL FROM TO Screens: ❑ Yes�No ❑ K-Pac Location Manufacturer's Name f Type Model No Diam. Slot size from ft.to ft Diam Slot size from ft.to ft. l C-"7� GraveVFillerpacked: ❑ Yes No ❑ Sizeofgravel/sand Materials placed from n to fl. Surface Seal: ❑ Yes `No To what depth?__ _ _ fl Material used in seal Did any strata contain unusable water? ❑ Yes ,pil"No Type of water? Depth of strata Method of sealing strata off PUMP: Manufacturer's Name Type: H.P. WATER LEVELS: t_aiid-su acc elevation above mean sea level i Static level �.� ,ft.below top of well Date.7- Artesian pressure Ibs per square inctr Date Artesian water is controlled by (cap,valve,etc WELL TESTS: Drawdown is anrount water level is lowered below static level Was a pump test made' ❑ Yes No If yes,by whom? Yield ___gal/min with rr�7ft.drawdown after his, Yidd gal/min with ft drawdown after hrs. Yield: gal./min.with _ft drawdown after_ _ --hrs Recovery data(rime taken as zero when pump turned of)(water level measured from well top to water level) Time Water Level Time Water Level Time Water Level Date of test Bailer test gal/min with ft.drawdown after hrs. Airtest gal./min.with stem set at A for hrs Artesian flow g.p m. Date Temperature of water Was a chemical analysis made? ❑ Yes llo - Start Date � Completed Date WELL CONSTRUCTION CERTIFICATION: I constructed and/or accept responsibility for construction of this well,and its compliance with all Washington well construction standards. Mate s ❑ use and t formmion reported above are true to best nowledge and b f. riller ❑Engineer Trainee Name(Pr G ;0-1 Drilling Comp; Driller/EngineerfTrainee Signature / Address b /� Driller or Trainee License No If TRAINEE, Contractor's Driller's Licensed No. Registration No 6-( (d�0f_ (7 e a Driller's Signature Ecology is an Equal Opportunity Employer ECY 050-1-20(Rev 3/05) The Department of Ecology does NOT warranty the Data and/or Information on this Well Report. We Seplfe&picesInc. n',v,�e 17924 67th Ave.N.E. • Arlington,WA 98223 (360)659.1881 e 1r$00-551.5570 • FAX(360)403-8431 START 4'�l'FINISH F,�� NAME: %— r� t l( DATE: t -� ADDRESS: 7 7b AT LYX CITY: 14? ZIP: PHONE:( ) �xJ'r ��^:,SELL:( ) FAX:( ) BILLING NAME: - BILLING ADDRESS: CITY: _ZIP: PHONE:(_ ) _ - CELL:( ) _FAX:( ) System Inspection: ❑ Tank Pumped ❑ Services by: ' Code: Approximate Sketch of System B House F Please refer to inspection paperwork for details. Extra Labor: ��- <<�'�--�--� S`� � ' Comments: 1�'��1`� �c>�� � n�� k .�-�- I Disposal - ----�` Fee 18.5 CPG Drainfield Area Concerns TAX r�L? ' I L' ❑ Effluent Surfacing ❑Greening ❑Sunken Areas ❑Vehicle Tracks ❑Tree Roots TOTAL -' ❑Other - Pmt. Mthd This septic system at the time of our inspection appears to be in working condition: ❑Yes ❑No (This inspection does not warranty the system in any way.) Number ,Ty Homeowners Responsibility: Homeowners are responsible for access to each component of the septic system.Ace Acme Se ti Se ce,Inc. is not responsible for any damage to the following when resulting from completing the ordered work:gas lines,water lines,electri inks,grass or landscape damage,or any other damage beyond the control of the contractor.Please see the reverse side for specific terms and conditions.Your signature demonstrates acceptance of these terms.Checks returned to the contractor unpaid are subject to additional fees. Signature Tech. Signature.— '"' I- - PAYMENT IS DUE UPON COMPLETION,UNLESS PREVIOUSLY AUTHORIZED BY MANAGEMENT. SPINV REV0208 �� i After recording return to: NO EXCISE TAX Arlington Municipal Airport REQUIRED 18204 591h Dr. NE MAR 14 2011 Arlington, WA 98223 I IIIIII qJJ 1pI I1111 lil itil 11i il lil itil 1111111 KIRKE SIEVERS,Snohori*County Treasurer 201�031 0360 P6,00 5 PG5 w KiRKF_ SIEVERS SN114 21 HI COUNT., TON Grantor: BrC1 nAOft -I- Grantee: City of Arlington Legal (abbrev.): _Ef. tX�}t 6 l I- A Tax parcel no.: 3135 Q_a(A ©®5 o Reference no.: �� LN ap 10 doc`4 se"D ?'CO, ARLINGTON MUNICIPAL AIRPORT AVIGATION EASEMENT WHEREAS, Br&ftAch eX , Hereinafter called"Grantor", is the owner of that certain parcel of land situated in the City of Arlington, County of Snohomish, State of Washington, to wit: SEC 22 TWP 31 RGE 05 RT-25A-1-25B-1-27A-31A) BEG 90OFT S OF NE COR SE1/4 SE1/4 TH N ALG SEC LN 1256 FT TPB TH W TO NP R/W TH S ALG SD R/W 171 FT TH E TO E LN SD SEC TH N ALG SD E LN TPB hereinafter called"Grantor's Property", and outlined on the attached map. (E*191T NOW, THEREFORE, for good and valuable consideration to the Grantor, the receipt and sufficiency of which is hereby specifically acknowledged,the Grantor, its successors and assigns, subject to the provisions herein contained,hereby grants, bargains, sells and conveys unto the City of Arlington, State of Washington, its successors and assigns ("Grantee"), for use and benefit of the public, a perpetual easement and right-of-way over that portion of the Grantor's above-described land starting at 292' Mean Sea Level (MSL), in the vicinity of Arlington Municipal Airport, for the purpose of the passage of all aircraft("aircraft"being 1 ' i I , defined for the purpose of this instrument as any device now known or hereafter invented, used or designated for navigation of, or flight in the air) by whomsoever owned and operated in the air space to an infinite height above the surface of the Grantor's property, together with the right to cause in said air space noise, vibration and all other effects that may be caused by the operation of aircraft landing at or taking off from, or operated at, or on Arlington Municipal Airport, located in Snohomish County, State of Washington. Grantor hereby waives, remises and releases any right or cause of action which Grantor has now, or which Grantor may have in the future against the Grantee, its successors and assigns, due to such noise, vibration, and other effects that may be caused by the operation of aircraft landing and taking off from, or operating on or near the Arlington Municipal Airport. The Grantor further covenants and agrees that upon said property (A) no use shall be permitted that causes a discharge into the air of fumes, smoke or dust which will obstruct visibility and adversely affect the operation of aircraft, nor shall any use be permitted which causes any interference with navigational facilities necessary to aircraft operation; and (B) no development or construction shall be permitted which will interfere in any way with the safe operation of aircraft in the air space over the land described herein or at or on the Arlington Municipal Airport. This easement shall be effective and shall inure to the benefit of the Grantee, its successors and assigns, until the Arlington Municipal Airport shall be abandoned and shall cease to be used for airport purposes. It is specifically understood and agreed that this easement, its covenants and agreements shall run with the land, which is described herein. The Grantor, on behalf of itself, its successors and assigns, further acknowledges that the easements herein granted contemplate and include all existing and future operations at Arlington Municipal Airport, acknowledging that future aircraft numbers and types will most likely increase and noise patterns may also increase, and that the rights, obligations and covenants herein set forth shall not terminate or vary in the event of changes in the flight volume or noise, traffic patterns, runway lengths or locations or characteristics or type or category of aircraft using the Arlington Municipal Airport, City of Arlington, State of Washington. OWNER: By: 2 it ACKNOWLEDGMENT STATE OF 10k2)A« YI ) SS. COUNTY OFF, The foregoing instrument was acknowledged before me by ,V(,I this day of , 20 NJ NOTARY PUBLI ' and for the s State of Washington, residing �yn .''�� 1a.•�T�'t� My commiss'on 3 �glglT LEGAL DESCRIPTION PARCEL # 31052200400500 , SEC 22 TWP 31 RGE 05 RT-25A-1-25B-1-27A-31A) BEG 90OFT S OF NE COR SE1/4 SE1/4 TH N ALG SEC LN 1256 FT TPB TH W TO NP R/W TH S ALG SD R/W 171 FT TH E TO E LN SD SEC TH N ALG SD E LN TPB 4 IT� NORTH - - 00970600004300 008706000051000087000000530000870800005500 f i - - 008706000052000087060000540000$740600005600 310522004003OF UPLAND DR 31052200400300 31052200402DOO - r\ i 00870600044800 I OOAT0G00002800OOB70GQ0002600 • -�. OD6706D0004700 00870800002700 00870600002500 00870600002400 - - - {' x z N v '00870600004600 00870000002900 00870000002300 r 31052200400400 00670600004500 - - - 00870600003000 � j N 00870600002200 00970600004400 OQA706000031p0 E i. A w 00870600002100 00970600004300 w 0OA70500003200 T J 00870600002000 - - 00870600004200 310522004OU200 008706000901DD z 0fi87D80Q003300 - i31052200402300 00870600001900 i 00870600004100 00870600003400, - - {_. - -- __7 - 0087060000f800 00870600004000 00670600003500 31062200400500 0OV0600001700 ' � 008746000OtB00 -- 0087060D000000 00870fi00003800 ------ 00870600093700 _ 006706WO01500 D IU H ---- --- CL EC-0] 0 y Ott iE itlM x, Li A U) N czO s w to la �4 7 gp XE- � � t 'S 4 . 'E W MOP- #�. W Eg s t7!gIP k i o- q +ft M, �a� 4 I "Ell, m I r.Maihka. lo q � 4 N .�nwu X 3� $€ RR C U a3� o :�:, �G n CZN - N Q) W () U 1 f III IiU�;� IQI I .7 ✓ .. nInJJrm^+'.+wl� a,hvf!wAa lao n.�4L vn a. ero�4.'w.m �e va� i p wn�wFrd�• mtlornx�ui�piquwlnldnii�lmwnmm�weommin�munuuiiv ,wm!�ae Mne inlim�iiimw�iuw+�inmlwumnnu�MXa 'fiup�lx^��. 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