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16404 SMOKEY POINT BLVD_BLD20130021_2026
" CITY OF ARLINGTON 238 N.OLYMPIC AVE.-ARLINGTON,WA 98223 PHONE:(360)403-3551 BUILDING PERMIT Address:16404 SMONEYPOINT BLVD,ARLINGTON Permit#:BLD20130021 Parcel#:31052900101500 Valuation:$9,000.00 -- eyPLICANT « CONTRACTO AFFORDABLE DENTAL SJS MECHANICAL SERVICES,LLC SJS MECHANICAL SERVICES,LLC LARRY&SHARON PREWITT KITTY SINGH KITTY SINGH 16404 SMOKEY POINT 3317 3RD AVE S#100 3317 3RD AVE S#100 ARLINGTON,WA 98223 SEATTLE,WA 98134 SEATTLE,WA 98134 Lic#:SUSMEMS951KL Exp:05/17/13 PL MINGCONTRAMR`_ _ SJS MECHANICAL SERVICES,LLC KITTY SINGH 3317 3RD AVE S#100 SEATTLE,WA 98134 Lie#:SUSMEMS951KL Exp:05/17/13 Lic#: Exp: JOB DFtCR1lE'�'I. Plumbing T.I. PERMIT TYPE: Commercial-Business-Alteration CODE YEAR: STORIES: 0 CONST TYPE: DWELLINGUNITS: 0 OCC GROUP: BUILDINGS: 0 OCC LOAD: 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, IT IS UNLAWFUL TO USE ORLEEN.GRAN GOR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANED.IBC110/IRC110. SALES TAX NOTICE Sale ton and c slr lion materials in the City of Arlington must be reported on your sales tax return form and coded City of Arl zz' Signature Print Name Date Released B to ARCHIVE F-1 APPLICANT ASSESSOR OTHER BLD20130021 CONDnIONS 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. None PFRNUT FEES Date Description Fee Amount Paid Balance Due 02/08/13 Plumbing Permit Fee $297.00 9.00 $297.00 Total Due: $297,00 $0.00 $297.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon. BLD20130021 (PT-LIVE) - PermitTrax by Bitco Software Page 1 of 1 BUILDING PERMIT PERMIT #: BLD20130021 OWNER: AFFORDABLE DENTAL-PREWITT, LAR... STATUS:APPLIED ADDRESS: 16404 SMOKEY POINT BLVD,ARLING... BALANCE: $0.00 ISSUED: CREATED: 2/7/2013 SCREENS:ISelect Screen... FUNCTIONS: Select Permit Function... - COMMERCIAL-BUSINESS-ALTERATION REVIEWS PRINT ADD NEW SUMMARY COMME... ID DESCRIPTION ASSIGNEQ.. DUE DA... LAST (#) REQ? DON... ASSIGN REMOVE 2000 C-Building I CYOUNG 2/14/20... 0 Y N 2008 C-Community Developme... ARUSKO 2/14/20... 0 Y N https:Hcoapermits.arlington.local/PermitTrax/Module_Permits/Permits Permit/Permit Reviews.asp... 2/7/2013 .� �. I I ., �i ., r COMMERCIAL PLUMBING PERMIT APPLICATION Department of Community Development City of Arlington • 238 N Olympic Ave. •Arlington, WA 98223 - Phone (360)403 3551 • FAX(360)403 3418 THIS APPLICATION MUST BE ACCOMPANIED BY THREE(3)SETS OF CONSTRUCTION DRAWINGS,AND THREE (3) SETS OF FIXTURE SPECIFICATIONS(CUT SHEETS). CALCULATIONS ARE REQUIRED FOR GREASE INTERCEPTOR IF APPLICABLE. Type of Permit: ® Commercial Kcommercial Addition/Alteration (p) Industrial Project Address: I "� �� '-4 Parcel ID#; Lot#: Subdivision: Project Description: A [�aUe- be4a1 -C i Valuation: S 9000 Owner: Phone Number: Address: City: State: Zip Code: Contact Person: Phone Number: Cell Phone: _Fax: - Z04, i -04'42 E-mail: Address:3i(T 3f � > 100 City: SeL —State: LOA Zip Code: 7`7Kt3 c( Please List quantity of fixtures Below: 3 4 r- 6,J U a-- ��� � ��^p�otj I Q WATER BATH TUB SHOWES LAVATORIES CLOSET CLOTHES WASHER LAUNDRY TUBS FLOOR DRAINS FLOOR SINKS SINKS URINALS SUMPS DISHWASHERS WATER HEATERS ROOF DRAINS WATER PIPING DWV ALTER/REPAIR AWN SPRINKLERS DRINKING FOUNTAINS MISC PLUMB FIXTURE GREASE INTERCEPTOR GREASE TRAP Contractor: S S �G�'i lC.a '�-mac' CLK - Phone Number: —Vo--?(o 3033C1 Address: City: ' State: Zip Code; 1 Contractor's License Number: SISS i°'1 C M59 5 i K.L Expiration: S In 201 41 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 regulation of the State of Washington. !vim 2 -7-- 13 piicants Sig ry�ture Date 1 PrintAppli Name RECEIVED FOR STAFF USE ONLY �) �{ FEB p 7 2013 Permit# Accepted By Amount Received Receipt# Q e EN I ER I 1 rr r•l ,!, , • I �a; COMMERCIAL PLUMBING PERMIT APPLICATION Department of Community Development City of Arlington - 238 N Olympic Ave. -Arlington,WA 98223- Phone(360)403 3551 - FAX(360)403 3418 WASTEWATER DISCHARGE SURVEY FORM (Please complete form and submit to Permit Center) NOTE. Arlington Municipal Code 13.08.590 requires that any and all commercial or industrial dischargers will not discharge to the City of Arlington Sanitary Sewer System without a negotiated discharge agreement. This survey will help us determine whether your business will require an agreement. 1. Type of Permit: commercial ([]) Industrial 0 Commercial Addition/Alteration 2. Proposed Building Use: 0 Restaurant ® Medical ® Industrial 0 Residential ® Commercial (®Automotive Based Q Machine Shop Other: 3. Does the plumbing system currently have a grease interceptor? ® Yes ,�1�0 ® Don't Know 4. Date grease trap/interceptor was last cleaned(provide service record): r 0 Don't Know 5. Does the plumbing system currently have a oil/water separator? O Yes N`8 ® Don't Know 6. Date oil/water separator was last cleaned (provide service record): ® Don't Know 7. Is water used in the business process (washing, rinsing,cooling)? O Yes o No 9,.11on't Know 8. Does your business require a NPDES permit? 0 Yes o No ,P, AGA Know � 6 f "' Contact Person: to t (�C `- L Phone Number: ?&,-N0—U33"( 1 Cell Phone: Fax:% _� 3 Z E-mail: The above information is complete and accurate to the best of my knowledge. .)understand that any changes in the sewage discharge from the site must be reported to the City of Arlington Public Works Utilities Division / Wastewater Department immediately by contacting 360-403-3526. Authorized Signature: ~vl c Date: Office Use On1v Comments: Date Received: Survey Received By: Assembly Required: ❑ DCVA ❑ RPBA ❑ AVB ❑ Other Inspection Required: ❑ YES ❑ NO COMMERCIAL PLUMBING PERMIT APPLICATION Department of Community Development City of Arlington• 238 N Olympic Ave. •Arlington,WA 98223- Phone (360)403 3551 , FAX(360)403 3418 CROSS-CONNECTION SURVEY FORM (Please complete form and submit to Permit Center) NOTE. The Rules and Regulations of the State of Washington Department of Health require that certain premises install backflow prevention assemblies(WAC 246.290.490). Backfl'ow prevention assemblies shall be installed at any premise where, in the judgment 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. Type of Permit: (3 Commercial ommercial Addition/Alteration (❑) Industrial Proposed Building Use: ® Restaurant C) Medical ® Industrial Residential 0 Commercial J2-Other: LAA-a- Contact Person: Phone Number: 2'0G-,X'3 - a 3 u Cell Phone: Fax: 2C�L`V3- (Y-LLf2-" E-mail: Zz)k-" Please check all appliances and/or applications that are permanently to the water supply and apply to your proposed USE and OPERATION. 0 Ice Maker 0 Dialysis Equip. O Air washers 0 Swimming Pools 0 Fire Sprinkler © Es Mach.Espresso Hydrotherapy Sprinkler w/chemicals p ® CD Steam Generators Hot Tub/Spa �Equip ® Carbonated Bev. . © Dental Equip. 0 Dye Vats (:D Ice Machine O Lawn Irrigation 0 Fume Hoods Q Laboratory Equip. 0 Pressure Washers ® Coffee Urn/Espress, 0 Well on property 0 Degreasers 0 Autoclave/Sterilizers ® Cooling Towers 0 Aquarium ® Decorative Fountain ® Other: Authorized Signature:, l k"/-i �_ Date: —7'I'�> Office Use Only Comments: Date Received: Survey Received By: Assembly Required: ❑ DCVA ❑ RPBA ❑ AVB ❑ Other Inspection Required: 0 YES ❑ NO I 1 BUILDING INSPECTION REPORT G1T Y o� Permit No.. dry 2-1 Address: 61100 y So, �r 1&40- Contractor: = &&28, Owner: Am2aA64- Lk�- M—1 Date: -�_?- /1113 APPROVAL ® PARTIAL APPROVAL Ep VIOLATION ® CORRECTION REQUEST Corrections listed below MUST BE MADE before work can be approved Please contact inspector Was not able to perform inspection Call 360-435-0674 FOR RE-INSPECTION by 5:00 pm the day before LU 4- Inspector: Date: ` ® Under-floor ® Framing ® Gas Piping ® Footing ® Drywall, nailing ® Consultation ® Foundation ®Shear Nailing ® Groundwork ® Mechanical ®Grid ® Struct. Slab ® Wood Stove `)%,,R'ough-in ® Final ® Masonry CO Drainage ® Insulation 5 Other: BUILDING INSPECTION REPORT G1�v o� Permit No. 14-- 00 2/ Address: I(o Z/O il( SIv, 9.p{rNG�0 Contractor: �i✓� Owner: -�'= L�.��Q� �i Date: - APPROVAL ® PARTIAL APPROVAL ® VIOLATION ® CORRECTION REQUEST Corrections listed below MUST BE MADE before work can be approved Please contact inspector Was not able to perform inspection Call 360-435-0674 FOR RE-INSPECTION by 5:00 pm the day before Inspector: ® Under-floor ® Framing ® Gas Piping ® Footing ®Drywall, nailing ® Consultation ® Foundation ®Shear Nailing ® Groundwork ® Mechanical ®Grid ® Struct. 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