HomeMy WebLinkAbout17514 74TH DR NE_077443_2026 INSPECTION REPORT
• Permit No.: -1 '7144 3 Lot#: 2-4
Address: 1191 y 7 L( 0 A-
Contractor: t-h M!±� ,4
• Owner:
Date: 2--1 3-0 6
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.
Ole— Lis
Inspector: i Date: 2-_13_®6
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:
!D ®3
INSPECTION REPORT
Permit No.: ®"7 1 qy 3 Lot #: Z,(6
Address: 1 -7 S'i y -7 Y V^-
Contractor: 1-h,4 .4 t4-
Owner:
Date: ! 2_-1 3-01
UAPPROVAL ❑ 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 AT\'Drywall, Nailing ❑ Consultation
❑ Foundation ❑ Shear Nailing ❑ Groundwork
❑ Mechanical ❑ Grid ❑ Struct. Slab
❑ Wood Stove ❑ Rough-in ❑ Final
❑ Masonry ❑ Drainage ❑ Insulation
❑ Other:
INSPECTION REPORT
• Permit No.: C77 7`1'V2 Lot#:
Address: //7Sl
Contractor: /9il,V1.7ye
• Owner:
Date: �APPROVAL PARTIAL APPROVAL
°� y El❑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 Insulation
❑ Other:
-INSPECTION REPORT
• Permit No.: 0 2 - -12 L/ot #: a�
Address: / 2.7-
Contractor: `��' « /G W
r • Owner:
Date:
G—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.
Sc
dt/ �
Inspector: 41AZDate: Y d
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:
pft4 INSPECTION REPORT yE16
• Permit No. #: G
Address: 7 /,W t ' :—
Contractor:
• ♦ Owner:
Date:
p� 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: 44zt� Date: 11"'.;22—O 7
TYPE OF INSPECTION REQUESTED
❑ Under-floor ❑ Framing ❑ Gas Piping
❑ Footing ❑ Drywall, Nailing ❑ Consultation
❑ Foundation ❑ Shear Nailing ❑ Groundwork
❑ Mechanical ❑ Grid ❑ Struct. Slab
❑ Wood Stove �3'Rough-in ❑ Final
❑ Masonry ❑ Drainage ❑ Insulation
❑ Other:
r'-A"Sc'
INSPECTION REPORT
• Permit No.:
Address: _ 17 6-/41 - 7V
Contractor: �Afc/,•l,
• • Owner:
Date: Z/
❑ APPROVAL YPARTIAL 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 it Gas Piping
❑ Footing ❑ Drywall, Nailing ❑ Consultation
❑ Foundation ❑ Shear Nailing ❑ Groundwork
❑ Mechanical ❑ Grid ❑ Struct. Slab
❑ Wood Stove 16 Rough-in ❑ Final
❑ Masonry ❑ Drainage ❑ Insulation
❑ Other:
INSPECTION REPORT 38
• Permit No.: - 7�fZ Lot #: �6
Address: l7 S`/�f' 2 yam`'
Contractor: M4tgtjt-t
• 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: Dater "
TYPE OF INSPECTION REQUESTED
❑ Under-floor ❑ Framing ❑ Gas Piping
❑ Footing ❑ Drywall, Nailing ❑ Consultation
❑ Foundation 0 Shear Nailing ❑ Groundwork
❑ Mechanical ❑ Grid ❑ Struct. Slab
❑ Wood Stove ❑ Rough-in ❑ Final
❑ Masonry ❑ Drainage ❑ Insulation
❑ Other:
q.&ir-
INSPECTION REPORT
e�
'7'-(Y 3
Permit No.: o7 I*W Lot #: 2_6
Address: I -1 6-0 Sc -7 y D/2
Contractor: t�r. ��►
• Owner:
Date: 1 l — 0 7
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.
c
Inspector: T Date: j It 2—' -
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
• Permit No.: O) 2�/41.? Lot #: a G
Address: f 7 S 141 2 Srt4 .Q,--
Contractor:
• Owner:
Date:
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.
Are f
Inspector: Date: /0 -l3—o"7
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
• Permit No.:4:�9 7 w,1-& Lot #: �to�
Address: y — 2
Contractor: LoyA
• a, Owner:
— ' Date: l a""0 ' Q
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.
( t14&42 t oJ. L„loq IIS q OQ��ov
Inspector: Date: /0 —1,2_t72
TYPE OF INSPECTION REQUESTED
❑ Under-floor ❑ Framing ❑ Gas Piping
❑ Footing ❑ Drywall, Nailing ❑ Consultation
Of Foundation ❑ Shear Nailing ❑ Groundwork
❑ Mechanical ❑ Grid ❑ Struct. Slab
❑ Wood Stove ❑ Rough-in ❑ Final
❑ Masonry ❑ Drainage ❑ Insulation
❑ Other:
11. 31
INSPECTION REPORT
Permit No.: 02"I?yy-.? Lot #:
Address:
Contractor:
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.
-fir �' � ✓17 �`' -
r
Inspector: Date:
TYPE OF INSPECTION REQUESTED
❑ Under-floor ❑ Framing ❑ Gas Piping
4 Footing ❑ Drywall, Nailing ❑ Consultation
❑ Foundation ❑ Shear Nailing ❑ Groundwork
❑ Mechanical ❑ Grid ❑ Struct. Slab
❑ Wood Stove ❑ Rough-in ❑ Final
❑ Masonry ❑ Drainage ❑ Insulation
❑ Other:
Ib 01- I ��
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CITY OF ARLINGTON
238 N.OLYMPIC AVE.-ARLINGTON,WA.98223
PHONE:(360)403-3421
PERMIT FEES/ RECEIPT
DATE: Wednesday,October 03,2007
PERMIT#: 07-7443
PROJECT ADDRESS: 17514 75TH DRIVE NE, ARLINGTON
LOCATION:
APPLICANT: -0-HIMALAYA HOMES
9633 MARKET PL#201
LAKE STEVENS,WA 98258
425.377,8600
*FEE SUMMARY:
Description Fee Amount Paid balance Due
Permit Fee $1,000.00 ($1,000.00) $0.00
C-Building Permit Fee $1,729.75 ($1,729.75) $0.00
Plumbing Fixtures-14 $140.00 ($140.00) $0.00
C-Plumbing Permit Fee $25.00 ($25.00) $0.00
Fumace/Unit Heater-1 $15.00 ($15.00) $0.00
Ventilation Fans-4 $28.00 ($28.00) $0.00
Dryer-1 $11.00 ($11.00) $0.00
Metal Fireplace&Chimney-1 $11.00 ($11.00) $0.00
Water Heater $15.00 ($15.00) $0.00
Gas Piping I-5 Outlets-1 $6.00 ($6.00) $0.00
C-Mechanical Permit Fee $24.00 ($24.00) $0.00
C-Building Plan Review Fee $124.34 ($124.34) $0.00
C-State Building Code Surcharge $4.50 ($4.50) $0.00
Total Due: $3,133.59 ($3,133.59) $0.00
*FEES ARE ESTIMATED BASED ON INFORMATION PROVIDED AT SUBMITTAL-SUBJECT TO CHANGE
PAYMENT TRANSACTIONS:
Date Receipt# ' Method/Payge Paid,
9/7/2007 CRCT3334 Cash/ ($1,000.00)
No Fee Description! ($1,000.00)
10/3/2007 REC000061 Check 51878/-0-HIMALAYA HOMES ($2,133.59)
C-Building Permit Fee ($1,729.75)
C-Mechanical Permit Fee ($24.00)
C-Building Plan Review Fee ($124.34)
C-State Building Code Surcharge ($4.50)
C-Plumbing Permit Fee ($140.00)
C-Plumbing Permit Fee ($25.00)
C-Mechanical Permit Fee ($15.00)
C-Mechanical Permit Fee ($28.00)
C-Mechanical Permit Fee ($11.00)
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" WGLE FAMILY RES )ENCE
BUILDING PERMIT APPLICATION
G� 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: Parcel ID#: 0 9 °9 c u .= Coo
Lot#: `'' Subdivision: U Uhl Q
Project Description: 1-1-
Owner: r t" t(/1 l I+' - Phone Number: - /-3 7 7- 'Qe�,Ga
Address: �/) r'I^�{' �� �alcity: State: I-'Vf4 Zip Code: q-�5 9
Contact Person:_ P} P��� L /l�/�/J(J� Phone Number: i `.�/,'
Cell Phone: , 6 1 Fax:(����/ 77 71�1/��E-mail:
Address: /�i�31'Yt�I'�( �� City: l State: "L �° Zip Code:
Lending Agency- ,`r 4\ Phone Number: Af/4
Address: City: State: \ Zip Code: \
Contractor: Phone Number: 7�'� 37/ • Y/jp 20
Address: IV�✓7 City: State: / L Z C I`>
/ip Code: /�)��
Contractor's License Number: f +- I,l FT L'`r?' ��_� Expiration:
Plumbing Contractor -SoUv I�/,�,J /�/I�'r/'1/I/i", {i1 Phone Number: 3LR�- GN 7LT'
Address: City: u`�')State:/-Jlq Zip Code:
�{
Contractor's License Number: � / Expiration:
Mechanical Contractor: /!!� <,_ 21J, Phone Number: �S
Address: 2 City; State: Zip'Code:
Contractor's
Contractor's License Number: Expiration:_
FOR STAFF USE ONLY
c7-7Kti �i A[� J /0vo 07
Permit# Accepted By Amount Received Receipt# Date Received
WEB Forms-46 Page 1 of 2 ^"" 5/05 dwa' `
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°STY °� NGLE FAMILY RES, JENCE
� BUILDING PERMIT APPLICATION
�lr oho 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)
Plumbing Fixtures Accessory Main Unit#Total Fixture Total Number Fixtures
X
Dwelling Unit Residence Units
Multiplier
Bar Sink X 1.0 = Q
Bathtub or Combination Bath/Shower X 4.0 = '
Clotheswasher X 4.0 =
Dishwasher X 1.5 = �.S
Hose Bibb X 2.5 = S
Kitchen Sink / X 1.5 = j
Laundry Sink X 2.0 = 42
Lavatory(Bathroom Sink) X 1.0 =
Shower(Stand Alone)Each Head X 2.0 =
Water Closet(Toilet) X 2.5 = s
Whirlpool Bath or Combination �^I X 4.0 =
Bath/Shower l
Water Heater
Other Total Fixture
Units
Traps(other than above items)
Column Totals
Estimated Project Valuation
Building Square Footage r/-7-7 /
1st Floor_ 2nd Floor Sd Floor
zJ
Basement )�All SbF_ Deck Garage 7
Water Supply Piping
A. Fixture Units: Number of Fixtures X Fixture Units=Total Fixture Units
B. Distance from meter to most remote outlet: feet.
C. Difference in elevation between meter and highest fixture: feet above meter or feet below meter.
D. Pressure in street main. 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 propefty will be in accordance with the laws,rules and regulation of the State of Washington.
Applicants Signature Date
FOR STAFF USE ONLY
Permit# Accepted By Amount Received Receipt# Date Received
WEB Forms-46 Page 2 of 2 5/05 dwa
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03/30/2007 1-5:30 3604357944 CITY OF ARLINGTON U PAGE 02/03
0"y 04 City of Arlington
• Public Works Utilities Division
Water Department .ph.360A03.3526
CROSS CONNECTION SURVEY
Residential
FOR OFFXC)c USE ONLY
Date Received: Survey reviewed by:
Saniey accepted by:
Assembly Required: [] No ❑Yes DcvA RPBA Inspection
Type of Residence Single Family ❑ DuPlex ❑ Triplex ❑ Apartment #of Units ❑ Other
QyProject Site Address._
Property Tax O1#: faot
Building Permit 0: Slabd"ion:
Building size: #of stories Project description: �--� —
property Ownw. � Q
Property 0VM6e8 mailing addx-ess ��7 ��/ g�s�
Property Owner's Phone# .�> D Lp 04. Fax# S L--�7�O
�rAN:
J
Occupant/Contact's 02w:
pccupant/Contact"s mailing t8 ddms:
Occupmt/Contacf s Phone# Fax# a�_ •.. ;
.. + 13M
1 6aclfto `
ne Rules and Regulations of the State of Washington Department of Health require that certain premises instafiremise whet,in
prevention assemblies,(WAC 246.290.490). Backflow prevention assemblies shall be installed at any p
-the judgement of the City of Arlington Cross Connection Control Specialist,the nature of activities on the promise may
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03/30/2007 15:30 3604357944 CITY OF ARLINGTON U PAGE 03/03
City of Arlin 7,ton Utilities]Division CKO Connection Sure
lPxo a Site Address:
Name of peMon filling out sure lease tint):
Place a check mark next to all equipment/fixtures listed below that are,or will be,permanently of Occasionally
connected to water for use at your residence(single family,multi-family,mobile,etc.)
.- Tollets o Shampoo Basin
Si*s(kitchen,bathroom,etc.) ❑ Drinking Fountains
o Janitax sitnlc to Film Processors
-bj; Hose Bib(outside f meet) ❑ Photo Developing Siuks/Tanks&W•
1K Bath tub a Solve Heating cyst=
.'gr Shower a HeaftS system u&g water
\
4 Dishwasher v Heating Boilers
�r Garbage disposal ❑ Boiler Feed Lines
\ Ice maker ❑. Bidets
la- Clothes Washer ❑ Dialysis Equipment
a Aix'Conditioner ❑ Medical Equipment
d Fire Spritxkler System o Water Treatment/Filtration System
c) Lawo Sprinkler system
d Decorative pond/fountain o pLivate Well on property
v Hot tub
o Swimming pool
The above inforatation is complete and accurate to
the beat my kuowledge. l understand that any
changes in equipment connected to the domestic .
waW system must be reported immediately to the
City of Arlington Utilities Division as a condition of
continued service. '
Print name -t
Date
_ � r
Nimmm
NONE„ rim
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C.) Y O1,
City of Arlington
�! o Community Development
r'�ING,S Permit Center
REQUEST FOR REVIEW
NAME: w,6, 1 C,4 yv`ej BP #: o 7- -7 ;1
DATE: b - 1 3- U-7 RETURN THIS FORM BY: C- zz - Q r
PROJECT SUMMARY: F K
i RESPCNvING CEP,�N 1^ FN4 i 5
TOM C., FIRE DAVE A., BUILDING
UTILITIES KERRY W., BUILDIN
BILL B., NATURAL RESOURCES SCOTT B., BUILDING
ENGINEERING YVONNE P., PLANNING
SHERRI PHELPS, BUS LIC CWA., CONSULTANT
DERYL T., MARYSVILLE UTIL JIM T., CONSULTANT
SUBMITTAL INFORMATION IS ATTACHED. Please review the information and return this form and your
comments in memo form to the Permit Center. If you have no comments, please return the form with the
"Okay to Issue" box checked.
PLEASE MARK ONE BOX, SIGN, DATE, AND RETURN THIS FORM TO THE PERMIT CENTER.
COMMENTS FOR THIS REVIEW ARE IN THE ATTACHED MEMO
NO COMMENT FOR THIS REVIEW, OKAY TO ISSUE PERMIT
❑ COMMENTS
REVIEWED BY 11kV111 DATE D
C� Y Of,
City of Arlington
-7 o Community Development
?lxNG,� Permit Center
REQUEST FOR REVIEW
NAME: HIrnc, IC,%4!rN h ovv�.e�- BP #: u7-
J
DATE: - 15- u-1 RETURN THIS FORM BY:
PROJECT SUMMARY: yitj 5 F K
IRESP0NDiNG DEPAR-1IVIE"JTS
TOM C., FIRE DAVE A., BUILDING
UTILITIES KERRY W., BUILDING
BILL B., NATURAL RESOURCES SCOTT B., BUILDING
ENGINEER1,NXI
SHERRI PHELPS, BUS LIC CWA., CONSULTANT
DERYL T., MARYSVILLE UTIL JIM T., CONSULTANT
SUBMITTAL INFORMATION IS ATTACHED. Please review the information and return this form and your
comments in memo form to the Permit Center. If you have no comments, please return the form with the
"Okay to Issue" box checked.
PLEASE MARK ONE BOX, SIGN, DATE, AND RETURN THIS FORM TO THE PERMIT CENTER.
❑ COMMENTS FOR THIS REVIEW ARE IN THE ATTACHED MEMO
NO COMMENT FOR THIS REVIEW, OKAY TO ISSUE PERMIT
❑ COMMENTS
REVIEWED BY - �_- DATE <
Gl-V Y Ur
City of Arlington RECEOVE [D
7 Community Development JUN 18 2007
�lrNG"�0 Permit Center
Utilities ®iv.
REQUEST FOR REVIEW
NAME: H BP #: o 7- -7H�-3
J
DATE: - 15- a-7 RETURN THIS FORM BY:
PROJECT SUMMARY: _�„� F IZ
1:ESPCNDi"JG DEPr^-,RT^VIEINTS
TOM C., FIRE DAVE A., BUILDING
UTILITIES KERRY W., BUILDING
BILL B., NATURAL RESOURCES SCOTT B., BUILDING
ENGINEERING YVONNE P., PLANNING
SHERRI PHELPS, BUS LIC CWA., CONSULTANT
DERYL T., MARYSVILLE UTIL JIM T., CONSULTANT
SUBMITTAL INFORMATION IS ATTACHED. Please review the information and return this form and your
comments in memo form to the Permit Center. If you have no comments, please return the form with the
"Okay to Issue" box checked.
PLEASE MARK ONE BOX, SIGN, DATE, AND RETURN THIS FORM TO THE PERMIT CENTER.
❑ COMMENTS FOR THIS REVIEW ARE IN THE ATTACHED MEMO
NO COMMENT FOR THIS REVIEW, OKAY TO ISSUE PERMIT
❑ COMMENTS
REVIEWED BY & DATE ,0 ' ���"
i •
City of Arlington
Community Development
Permit Center
REQUEST FOR SFR REVIEW
RESPONDING DEPARTMENT: PLANNING
BP #: o -7- 7 y'rJ NAME:
J
ADDRESS: 1-75/ Y -7 5rh Pr.v,, N��
PLEASE RETURN FORM WITHIN 3-5 WORKIN DAY FROM
Lj- Mitigation Fees Verified:
School Mitigation Fees:
Community Park Impact Fee:
Mini-Neighborhood Park Impact Fee:
Trip Impact Fees: � IT CENTEP
Set Backs Verified Required/Proposed: Zoning: L
Front Yard/ Alm S' .,AK
Street Setback 2G ear Yard Setback 2 Side Yard Setbacks 10
Lot Coverage Verified
�- Shade Trees Verified on Site plan
Height Verified (Called out on Site plan)
SUBMITTAL INFORMATION IS ATTACHED. Please review the information and return this form and your
comments, either on the drawings or in memo form, to the Permit Center. If you have no comments,
please return the form with the "Okay to Issue" box checked.
PLEASE MARK ONE BOX, SIGN, DATE, AND RETURN THIS FORM TO PERMIT CENTER.
IN COMPLIANCE WITH LAND USE CODE - OKAY TO ISSUE
L] NOT APPROVED - ADDITIONAL INFORMATION REQUIRED
o (SEE ATTACHED REDLINES OR MEMO FOR COMMENTS)
REVIEWED BY DATE / d
G1� Y �f,
City of Arlington
o Community Development
� -ING� Permit Center
REQUEST FOR REVIEW
NAME: -� _< --BP #:
DATE:_ f0 - 15- U-7 RETURN THIS FORM BY-. b Zi -
PROJECT SUMMARY: ,nl F IZ,
RESPCNDiIJG DEP:R_1", BENTS
TOM C., FIRE DAVE A., BUILDING
UTILITIES KERRY W., BUILDING
BILL B., NATURAL RESOURCES SCOTT B., BUILDING
ENGINEERING YVONNE P., PLANNING
SHERRI PHELPS, BUS LIC CWA., CONSULTANT
DERYL T., MARYSVILLE UTIL JIM T., CONSULTANT
SUBMITTAL INFORMATION IS ATTACHED. Please review the information and return this form and your
comments in memo form to the Permit Center. If you have no comments, please return the form with the
"Okay to Issue" box checked.
PLEASE MARK ONE BOX, SIGN, DATE, AND RETURN THIS FORM TO THE PERMIT CENTER.
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