HomeMy WebLinkAbout17430 79TH DR NE_056629_2026 G I TY OF ARL I IVGTOhI
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Orner: SEATTLE PACIFIC HOME PO BOX 123 MARYSVILLE 98270
Value of Work: $4, 000. 00 Tax ID: 010179-000-036-00 Phone: 360. 657. 4144
Describe Work: CONSTRUCT 100 S9 FT DECK
Proposed Use: SFR
Legal Description: MAGNOLIA ESTATES LOT 36
Job Address: 17430 79TH DR NE
Contractor's Name Type Address License*
SEATTLE PACIFIC HOMES GEN PO BOX 123 SEATTPHO05BU
TOTALS Fee I
Permit Fee $109, 5,0
Plan Fee $71. 18
State fee $4. 50
SIGNATUR '.
TOTAL FEE. . . . . . . . . . . . . . . . . $185. 18 I HE tE R' Y THAT I HAVE
AND E NLD 'I.IS APPLICATION AND
PAYMENTS. . . . . . . . . . . . . . . . . . $0. 00 KNOW SAME TO BE TRUE AND COR-
RECT L PROVISIONS OF LAWS AND
TOTAL DUE. . -. . _ . _ . . . . . . . . . . $185. 18 ORDIINANCES GOVERNING THIS TYPE OF
WORK WILL BE COMPLIED WITH WHETHER
DATE RECEIPT # SPEC1FIED HEREIN OR NOT.
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79TH DRIVE N. E M :� o o M
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MISCELLANEOUS 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 MUST BE ACCOMPANIED BY FOUR(4 SETS OF CONSTRUCTION DRAWINGS, SIX(6)
ACCURATE, FULLY DIMENSIONED PLOT PLANS AND TWO(2) SETS OF ENERGY CODE APPLICATIONS(IF
APPLICABLE).
Type of Permit: (check one) Residential ( )Commercial
rI s C� I61'7q- pi�0 -034
Project Address: 11L'S0 A)C AtL, CJ,2S2 OLJParcellD#:
'3L � r) r
Lot#:
Building Area(Sq Ft) I 0 U No.of floors: l Number of Buildings: NA
N 3(, 0 7 Y
- � S - �� y
Owner: S�G'f��� ���-' � �� �`�t S Phone Number:
Address: P. b ' V v x I I3 City: ./ (�^'y S VI �'- State: wn Zip Code: �l� 7b
Scope of Work: Ni`tt/ C— U n j (�V c,I io it D C) G
A detailed site plan/vicinity map,and construction drawings may be required depending on the scope of work. Please verify this with a
Community Development Permit Technician prior to submitting application for review. I // ,J /
Contractor: SC-d-fl �� " �)� o`'h�'� Lam`- Phone Number: 36 b b- S7 - "117 Y
Address: ; O 8 v ' pL City: �`'�yS�'���- State: A Zip Code: 'I� �-76
Contractor's License Number. � r r 1 OU,5- b L4 Expiration: I -3/ -0
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 State of Washington.
Applicants Signature Date
Print Applicants Name
RECEt!/ED
SEP 01 2005'
COA BUILDING DES'
Forms/MISC-1
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