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HomeMy WebLinkAbout18821 Crown Ridge Blvd_BLD6840_2026 CITY OF ARLINGTON 18204 59th Avenue NE,Arlington,WA 98223 INSPECTIONS:360-403-3417-Permit Center:360-403-3551 BUILDING PERMIT 135 S FRENCH AVE Permit#: 6840 Parcel#:31051100102000 PERMIT EXPIRES 180 DAYS AFTER DATE OF ISSUANCE. Scope of Work:REMOVE AND REPLACE WITH NEW SAME MODEL Valuation:8000.00 DEVICE(1)4"FEBCO 850,DCVA,FOR IRRIGATION CROSS CONNECTION PROTECTION.CURRENT DEVICE HAS FAILED SECOND CHECK. OWNER APPLICANT CONTRACTOR ARLINGTON SCHL DIST 16 MacDonald Miller 315 N FRENCH AVE PO BOX 47983 ARLINGTON,WA 98223 Seattle,WA 98146 206-755-2954 LIC:MACDOFS798P9 EXP:10/25/2027 LIC:602 254 260 EXP:12/31/2026 MECHANICAL CONTRACTOR MENERNM PLUMBING CONTRACTOR LIC#: EXP: LIC#: EXP: JOB DESCRIPTION - PERMIT TYPE: COMMERCIAL PLUMBING CODE YEAR: STORIES: 0 CONST.TYPE: DWELLING UNITS: OCC GROUP: E;Education BUILDINGS: OCC LOAD: - PERMIT APPROVAL The issuance or granting of this permit shall not be construed to be a permit for,or approval of,any violation of this Code or any other ordinance or order of the City,of any state or federal law,or of any order,proclamation,guidance advice or decision of the Governor of this State.To the extent the issuance or granting of this permit is interpreted to allow construction activity during any period of time when such construction is prohibited or restricted by any state or federal law,or order,proclamation,guidance advice or decision of the Governor of this State,this permit shall not authorize such work and shall not be valid.The building official is authorized to prevent occupancy or use of a structure where in violation of this Code,any other City ordinances of this jurisdiction or any other ordinance or executive order of the City,or of any state or federal law,or of any order,proclamation,guidance advice or decision of the Governor.The building official is authorized to suspend or revoke this permit if it is determined to be issued in error or on the basis of incorrect,inaccurate or incomplete information,or in violation of any City ordinance,regulation or order,state or federal law,or any order,proclamation,guidance or decision of the Governor. 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 OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED.IBCl l0/IRC110. SALES TAX NOTICE: Sales tax relating to construction and construction materials in the City of Arlington must be reported on your sales tax return form and coded City of Arlington#3101. ad m yam°e ary bry Ammone Bembr ®ma 911erggO rtMa ager�°CNRmm°ne Bembry ybz28 Pe� ropaerc_ 07/17/2026 Applicant Signature Date Building Official Date orw CONDITIONS Adhere to approved equipment Permit shall be onsite for inspection Call for inspection The property owner shall ensure that the construction project complies with all applicable zoning codes and regulations.The property owner shall also ensure that the construction project does not cause any adverse impact on the surrounding environment or community.The property owner shall be responsible for obtaining all necessary permits and approvals from the relevant authorities before commencing construction.The property owner shall ensure that the construction project complies with all applicable design review requirements. 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. PERMIT FEES Date Description Fee Amount 07/17/2026 Plumbing Commercial Plan Re\iew $148.67 07/17/2026 Processing/Technology $25.00 07/17/2026 Inspection $75.00 07/17/2026 Plumbing Base $25.00 Total Due: $273.67 Total Payment: $273.67 Balance Due: $0.00 CALL FOR INSPECTIONS Call by 3:30 pm for next day inspection,allow 48 hours for Fire Inspections When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon INSPECTION INFORMATION I Pass/Fail CITY OF ARLINGTON ` 18204 59th Avenue NE,Arlington,WA 98223 INSPECTIONS: 360-403-3417-Permit Center: 360-403-3551 BUILDING PERMIT 18821 CROWN RIDGE BLVD Permit#: 6840 PERMIT EXPIRES 180 DAYS AFTER Parcel#: 31051300300600 DATE OF ISSUANCE. Scope of Work:REMOVE AND REPLACE WITH NEW SAME MODEL Valuation: 8000.00 DEVICE(1)4"FEBCO 850,DCVA,FOR IRRIGATION CROSS CONNECTION PROTECTION.CURRENT DEVICE HAS FAILED SECOND CHECK. OWNER APPLICANT CONTRACTOR ARLINGTON SCHOOL DIST#16 MacDonald Miller MacDonald Miller Facility Solutions,LLC 315 N FRENCH PO BOX 47983 PO Box 47983 ARLINGTON,WA 98223 Seattle,WA 98146 Seattle,WA 98146 206-755-2954 206-768-3866 LIC:MACDOFS798P9 EXP: 10/25/2027 LIC:602 254 260 EXP: 12/31/2026 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: COMMERCIAL PLUMBING CODE YEAR: 2021 STORIES: 0 CONST.TYPE: DWELLING UNITS: OCC GROUP: E;Education BUILDINGS: OCC LOAD: PERMIT APPROVAL The issuance or granting of this permit shall not be construed to be a permit for,or approval of,any violation of this Code or any other ordinance or order of the City,of any state or federal law,or of any order,proclamation,guidance advice or decision of the Governor of this State.To the extent the issuance or granting of this permit is interpreted to allow construction activity during any period of time when such construction is prohibited or restricted by any state or federal law,or order,proclamation,guidance advice or decision of the Governor of this State,this permit shall not authorize such work and shall not be valid.The building official is authorized to prevent occupancy or use of a structure where in violation of this Code,any other City ordinances of this jurisdiction or any other ordinance or executive order of the City,or of any state or federal law,or of any order,proclamation, guidance advice or decision of the Governor.The building official is authorized to suspend or revoke this permit if it is determined to be issued in error or on the basis of incorrect,inaccurate or incomplete information,or in violation of any City ordinance,regulation or order,state or federal law,or any order,proclamation,guidance or decision of the Governor. 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 OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED.IBC 110/IRC 110. SALES TAX NOTICE: Sales tax relating to construction and construction materials in the City of Arlington must be reported on your sales tax return form and coded City of Arlington#3101. 07/17/2026 Applicant Signature Date Building Official Date CONDITIONS Adhere to approved equipment Permit shall be onsite for inspection Call for inspection The property owner shall ensure that the construction project complies with all applicable zoning codes and regulations.The property owner shall also ensure that the construction project does not cause any adverse impact on the surrounding environment or community.The property owner shall be responsible for obtaining all necessary permits and approvals from the relevant authorities before commencing construction.The property owner shall ensure that the construction project complies with all applicable design review requirements. 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. PERMIT FEES Date Description Fee Amount 08/06/2026 Plumbing Commercial Plan Review $148.67 08/06/2026 Processing/Technology $25.00 08/06/2026 Inspection $75.00 08/06/2026 Plumbing Base $25.00 08/06/2026 Credit Card Service $8.21 Total Due: $281.88 Total Payment: $281.88 Balance Due: $0.00 CALL FOR INSPECTIONS Call by 3:30 pm for next day inspection,allow 48 hours for Fire Inspections When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon INSPECTION INFORMATION Pass/Fail C 19.PLUMBING FINAL Approved CITY OF ARLINGTON ` 18204 59th Avenue NE,Arlington,WA 98223 INSPECTIONS: 360-403-3417-Permit Center: 360-403-3551 BUILDING PERMIT 18821 CROWN RIDGE BLVD Permit#: 6840 PERMIT EXPIRES 180 DAYS AFTER Parcel#: 31051300300600 DATE OF ISSUANCE. Scope of Work:REMOVE AND REPLACE WITH NEW SAME MODEL Valuation: 8000.00 DEVICE(1)4"FEBCO 850,DCVA,FOR IRRIGATION CROSS CONNECTION PROTECTION.CURRENT DEVICE HAS FAILED SECOND CHECK. OWNER APPLICANT CONTRACTOR ARLINGTON SCHOOL DIST#16 MacDonald Miller MacDonald Miller Facility Solutions,LLC 315 N FRENCH PO BOX 47983 PO Box 47983 ARLINGTON,WA 98223 Seattle,WA 98146 Seattle,WA 98146 206-755-2954 206-768-3866 LIC:MACDOFS798P9 EXP: 10/25/2027 LIC:602 254 260 EXP: 12/31/2026 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: COMMERCIAL PLUMBING CODE YEAR: 2021 STORIES: 0 CONST.TYPE: DWELLING UNITS: OCC GROUP: E;Education BUILDINGS: OCC LOAD: PERMIT APPROVAL The issuance or granting of this permit shall not be construed to be a permit for,or approval of,any violation of this Code or any other ordinance or order of the City,of any state or federal law,or of any order,proclamation,guidance advice or decision of the Governor of this State.To the extent the issuance or granting of this permit is interpreted to allow construction activity during any period of time when such construction is prohibited or restricted by any state or federal law,or order,proclamation,guidance advice or decision of the Governor of this State,this permit shall not authorize such work and shall not be valid.The building official is authorized to prevent occupancy or use of a structure where in violation of this Code,any other City ordinances of this jurisdiction or any other ordinance or executive order of the City,or of any state or federal law,or of any order,proclamation, guidance advice or decision of the Governor.The building official is authorized to suspend or revoke this permit if it is determined to be issued in error or on the basis of incorrect,inaccurate or incomplete information,or in violation of any City ordinance,regulation or order,state or federal law,or any order,proclamation,guidance or decision of the Governor. 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 OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED.IBC 110/IRC 110. SALES TAX NOTICE: Sales tax relating to construction and construction materials in the City of Arlington must be reported on your sales tax return form and coded City of Arlington#3101. ■ Ily signed by Ammone Bembry � iI =US,E=ammone.bembry@macmiller.com,0=10-Dona1d Ammone B e m b FaciCNSAlmtmoone Bembry fitting&Engineering Support /C�r_ 2026.08.07 2226 09-OT00• 07/1 7/2026 Applicant Signature Date Building Official Date CONDITIONS Adhere to approved equipment Permit shall be onsite for inspection Call for inspection The property owner shall ensure that the construction project complies with all applicable zoning codes and regulations.The property owner shall also ensure that the construction project does not cause any adverse impact on the surrounding environment or community.The property owner shall be responsible for obtaining all necessary permits and approvals from the relevant authorities before commencing construction.The property owner shall ensure that the construction project complies with all applicable design review requirements. 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. PERMIT FEES Date Description Fee Amount 08/06/2026 Plumbing Commercial Plan Review $148.67 08/06/2026 Processing/Technology $25.00 08/06/2026 Inspection $75.00 08/06/2026 Plumbing Base $25.00 08/06/2026 Credit Card Service $8.21 Total Due: $281.88 Total Payment: $281.88 Balance Due: $0.00 CALL FOR INSPECTIONS Call by 3:30 pm for next day inspection,allow 48 hours for Fire Inspections When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon INSPECTION INFORMATION Pass/Fail C 19.PLUMBING FINAL Approved 4rtk( tot( WASHINGTON Permit Information - - , 1 'nformat;^ Permit# A26-0446 Parcel # 31051100102000 Building ID Location 135 FRENCH AVE Permit Type Commercial Permit Use Plumbing Zone Permit # Subdivision Applicant Name PERMIT SPECIALIST Address PO BOX 47983 Applicant Email permits@macmiller.com Phone 2067684062 Cell Owner Name ARLINGTON SCHL DIST 16 Address 315 N FRENCH AVE ARLINGTON, WA, 98223 Owner Email Phone Cell Contractor Address Contractor Email Phone Cell . ...r_._, ............_.. Type/Improveme Accessory/Struct nt ure Current Use Proposed Use Current Zoning 0 Proposed Zoning Project Cost Project Value Current Use And transferred to I worQ Proposed Changes Lot Width Lot Depth Map Number Total Area of Building &Accessory Total Area of All Man-made Improvements Structures (Sq Ft) (Sq Ft) General Notes Restrictions/ Variances ©Community Development Online Portal Page 1 of 4 August 6, 2026 08:47AM WASHINGTON Structure Information Structure Type # of Stories Usable Floor Area (Sq Ft) Structure Height # of Units Load per Floor (Lbs) Sign Dimensions # of Bedrooms # of Bathrooms Occupancy With Chairs Tables & Chairs Empty Room Foundation Foundation Type Footing Depth Material Foundation Information Setbacks Front& 0 0 Setbacks Right & 0 0 Rear Left Sides Setbacks Information Water Utility Public Sewage Utility Public Gas Utility Public Electric Utility Public Driveway Width # of Off Street # of Off Street Parking Loading Miscellaneous Information ©Community Development Online Portal Page 2 of 4 August 6, 2026 08:47AM 4rtk( tot( WASHINGTON Contacts Contact Name Type Project Address Phone ARLINGTON SCHL DIST 16 Owner 315 N FRENCH AVE ARLINGTON, WA, 98223 PERMIT SPECIALIST Others PO BOX 47983 206-768-4062 PERMIT SPECIALIST Applicant PO BOX 47983 206-768-4062 ©Community Development Online Portal Page 3 of 4 August 6, 2026 08:47AM 4rtk( tot( WASHINGTON Fees Fee Type Date Debit Credit Balance Permit Fees July 6, 2026 $0.00 $0.00 T O T A L $0.00 $0.00 $0.00 ©Community Development Online Portal Page 4 of 4 August 6,2026 08:47AM COMMERCIAL PLUMBING APPLICATION For Instruction/Checklist,please click here Site Address: 135 S French Ave,Arlington, Project Name: 2026-286LT/DCVA REPLACI Project Valuation: 8000 Preferred Contact: Owner G Contractor Project Description: REMOVE AND REPLACE WITH NEW SAME MODEL DEVICE (1) 4" FEBCO 850, DCVA, FOR IRRIGATION CROSS CONNECTION PROTECTION. CURRENT DEVICE HAS FAILED SECOND CHECK. Owner Details Owner Name: ARLINGTON SCHL DIST 16 Office No.: Email Address: Cell No.: Mailing Address: 135 S FRENCH AVE City: ARLINGTON State: I WASHINGTON Zip: 98223-2605 Contractor Details Contractor Name: I MACDONALD MILLER FACI Office No.: 206-768-4062 Email Address: permits@macmiller.com Cell No.: 206-755-2954 Mailing Address: I PO BOX 47983 City: SEATTLE State: I WA Zip: 98146 L&I Contractor License Number: I MACDOFS798P9 Expiration Date: 10/25/2027 PLUMBING PERMIT FEES (per fixture) Commercial plumbing permits are required to submit line drawings.A plan review fee of 65%per Table 4-6 for plumbing permits will be assessed at time of submittal. Includes two (2) inspections with permit. Type of Fixture IFNo. of Units Additional Plan Review fees III Alteration/repair piping Backflow Assembly Base Plumbing Fee Bath/Shower Combo Building Main Waste Clothes Washer Dishwasher Drinking Fountain Floor Drains Grease Interceptor Grease Trap Hose Bibb Icemaker/Refrigerator Irrigation—per meter Kitchen Sink& Disposal Laundry Tray Lavatory Medical Gas Piping< 5 Inlets/Outlets Medical Gas Piping for each additional Inlet/Outlet> 5 Miscellaneous—regulated by plumbing code (not otherwise specified) 4 Pretreatment Interceptor Re-inspection Fee (all) Roof Drains Shower(only) Sink(bar, service, etc.) Toilets Urinal Vacuum Breakers Water Heater Water Heater- Tankless PROPOSED BUILDING USE U New Addition/Alteration Medical U Automotive Based Industrial Office Restaurant Machine Shop Other: Repair or Replacement CROSS CONNECTION Please check all appliances that are proposed or permanently connected to the water supply. Ice Machine Dialysis Equip. Air washers Coffee Urn/Espresso Hydrotherapy Equip. Steam Generators Carbonated Bev. Dental Equip. Dye Vats Fume Hoods Laboratory Equip. Pressure Washers Degreasers Autoclave/Sterilizers Cooling Towers Hot Tub/Spa Decorative Fountain Fire Sprinkler Aquarium Swimming Pools Sprinkler w/chemicals Lawn Irrigation Well on property Other: WASTEWATER DISCHARGE Does the plumbing system currently have a grease interceptor? Yes No Don't Know Does the plumbing system currently have an oil/water separator? Yes No Don't Know Is water used in the business process (washing, rinsing, cooling)? Yes No Don't Know Does your business require a NPDES permit? Yes No Don't Know 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. Print Name: PERMIT SPECIALIST Date: 07/06/2026 WASHINGTON Permit Application #A26-0446 Location:135 FRENCH AVE Routing Details X Department: Permit Tech Intake Review - Deadline:July 13, 2026 - Status: In Progress Department: Permit Tech Final Approval - Deadline: July 13, 2026 - Status: Void Manual Void - Permit Application #A26-0446 Location:135 FRENCH AVE - by LaNay Hendrick- Permit Technician at July 15, 2026 02:53PM Status: Void Activity Type: Documents Review The following permit has been Void manually. Permit Application #A26-0446 Location:135 FRENCH AVE ©Community Development Online Portal Page 1 of 2 August 6, 2026 08:48AM WASHINGTON Record Actions New Permit Application #A26-0446 Location: 135 FRENCH AVE By LaNay Hendrick- Permit Technician at July 6, 2026 10:15AM Hello, A new permit application has been submitted for review. Please login to your CIVICGov Web Application account and visit the link below to view the permit details. https://www.civicgov4.com/wa_arlington/permits/details/574 If you cannot click on the link above, please copy and paste the entire link in the browser address bar. Sincerely, CIVICGov Team. Manual Void - Permit Application #A26-0446 Location:135 FRENCH AVE By LaNay Hendrick- Permit Technician at July 15, 2026 02:53PM The following permit has been Void manually. Permit Application #A26-0446 Location:135 FRENCH AVE ©Community Development Online Portal Page 2 of 2 August 6, 2026 08:48AM Permit#: 6840 Permit Date: 07/06/26 Permit Type: COMMERCIAL PLUMBING Project Name: 2026-286LT/DCVA REPLACE Applicant Name: MacDonald Miller Applicant PO BOX 47983 Address: Applicant, City, Seattle,WA 98146 State, Zip: Contact: Macdonald Miller Phone: 206-755-2954 Email: permits@macmiller.com Scope of Work: REMOVE AND REPLACE WITH NEW SAME MODEL DEVICE (1) 4" FEBCO 850, DCVA, FOR IRRIGATION CROSS CONNECTION PROTECTION. CURRENT DEVICE HAS FAILED SECOND CHECK. Valuation: 8000.00 Square Feet: 0 Number of 0 Stories: Construction Type: Occupancy E; Education Group: ID Code: Permit Issued: 07/15/2026 Permit Expires: 01/14/2027 Form Permit COMMERCIAL PLUMBING Type: Civic Plus PA26-0446 Number: Status: COMPLETE Assigned To: LaNay Hendrick Property Parcel# Address Legal Description Owner Name Owner Phone Zoning 31051300300600 18821 CROWN RIDGE ARLINGTON 681 Nursery,Primary BLVD SCHOOL DIST#16 &Secondary School Contractors Contractor Primary Contact Phone Address Contractor Type License License# MacDonald Miller 206-768-3866 PO Box 47983 CONSTRUCTION L&I MACDOFS798P9 Facility Solutions,LLC CONTRACTOR MacDonald Miller 206-768-3866 PO Box 47983 CONSTRUCTION COA 602 254 260 Facility Solutions,LLC CONTRACTOR Inspections Date Inspection Type Description Scheduled Date Completed Date Inspector Status 07/31/2026 C19.PLUMBING 07/31/2026 BUILDING Approved FINAL Plan Reviews Date Review Type Description Assigned To Review Status 07/06/2026 COMMERCIAL BUILDING Approved PLUMBING Fees Fee Description Notes Amount Plumbing Commercial Plan Review Table 4-1 $148.67 Processing/Technology $25.00 Inspection $75.00 Plumbing Base Permit Fee $25.00 Credit Card Service $8.21 Total $281.88 Attached Letters Date Letter Description 07/17/2026 Building Permit Payments Date Paid By Description Payment Type Accepted By Amount 07/17/2026 Ammone Bebry 322496112 Hannah Hardwick $8.21 07/17/2026 XBP Con£ $273.67 322496112 Outstanding Balance $0.00 Notes Date Note Created By: Incorrect address was entered on the application and the original permit.Correct address of 08/06/2026 Kristin Foster 18221 Crown Ridge Blvd.has been updated,and a new permit has been sent for signature. Uploaded Files Date File Name 08/10/2026 33688204-260624-0018 REVISED PLM 6840.pdf 07/17/2026 33280800-260624-0018 PLUMBING PERMIT 6840.pdf 07/15/2026 33244771-ES-F-LF850L+2543.pdf 07/06/2026 33051613-map.docx.pdf 07/06/2026 33051557-application.pdf Arlington School District Location of Work 135 S French Ave DCVA in Vault on Sidewalk Arlington, WA 98223 Irrigation DCVA, FEBCO Model-850, SN-F0207080924, 4" o , �► O : • J , ip • t T� i ) 1 . iLiL�-r�-fit] • � ,}� +� � l�l _ - i i y \I. .irk ),. FFFF r s.. ✓+ S n , eti v 4 CITY OF ARLINGTON ` 18204 59th Avenue NE,Arlington,WA 98223 INSPECTIONS: 360-403-3417-Permit Center: 360-403-3551 BUILDING PERMIT 18821 CROWN RIDGE BLVD Permit#: 6840 PERMIT EXPIRES 180 DAYS AFTER Parcel#: 31051300300600 DATE OF ISSUANCE. Scope of Work:REMOVE AND REPLACE WITH NEW SAME MODEL Valuation: 8000.00 DEVICE(1)4"FEBCO 850,DCVA,FOR IRRIGATION CROSS CONNECTION PROTECTION.CURRENT DEVICE HAS FAILED SECOND CHECK. OWNER APPLICANT CONTRACTOR ARLINGTON SCHOOL DIST#16 MacDonald Miller MacDonald Miller Facility Solutions,LLC 315 N FRENCH PO BOX 47983 PO Box 47983 ARLINGTON,WA 98223 Seattle,WA 98146 Seattle,WA 98146 206-755-2954 206-768-3866 LIC:MACDOFS798P9 EXP: 10/25/2027 LIC:602 254 260 EXP: 12/31/2026 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: COMMERCIAL PLUMBING CODE YEAR: 2021 STORIES: 0 CONST.TYPE: DWELLING UNITS: OCC GROUP: E;Education BUILDINGS: OCC LOAD: PERMIT APPROVAL The issuance or granting of this permit shall not be construed to be a permit for,or approval of,any violation of this Code or any other ordinance or order of the City,of any state or federal law,or of any order,proclamation,guidance advice or decision of the Governor of this State.To the extent the issuance or granting of this permit is interpreted to allow construction activity during any period of time when such construction is prohibited or restricted by any state or federal law,or order,proclamation,guidance advice or decision of the Governor of this State,this permit shall not authorize such work and shall not be valid.The building official is authorized to prevent occupancy or use of a structure where in violation of this Code,any other City ordinances of this jurisdiction or any other ordinance or executive order of the City,or of any state or federal law,or of any order,proclamation, guidance advice or decision of the Governor.The building official is authorized to suspend or revoke this permit if it is determined to be issued in error or on the basis of incorrect,inaccurate or incomplete information,or in violation of any City ordinance,regulation or order,state or federal law,or any order,proclamation,guidance or decision of the Governor. 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 OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED.IBC 110/IRC 110. SALES TAX NOTICE: Sales tax relating to construction and construction materials in the City of Arlington must be reported on your sales tax return form and coded City of Arlington#3101. ■ Ily signed by Ammone Bembry � iI =US,E=ammone.bembry@macmiller.com,0=10-Dona1d Ammone B e m b FaciCNSAlmtmoone Bembry fitting&Engineering Support /C�r_ 2026.08.07 2226 09-OT00• 07/1 7/2026 Applicant Signature Date Building Official Date CONDITIONS Adhere to approved equipment Permit shall be onsite for inspection Call for inspection The property owner shall ensure that the construction project complies with all applicable zoning codes and regulations.The property owner shall also ensure that the construction project does not cause any adverse impact on the surrounding environment or community.The property owner shall be responsible for obtaining all necessary permits and approvals from the relevant authorities before commencing construction.The property owner shall ensure that the construction project complies with all applicable design review requirements. 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. PERMIT FEES Date Description Fee Amount 08/06/2026 Plumbing Commercial Plan Review $148.67 08/06/2026 Processing/Technology $25.00 08/06/2026 Inspection $75.00 08/06/2026 Plumbing Base $25.00 08/06/2026 Credit Card Service $8.21 Total Due: $281.88 Total Payment: $281.88 Balance Due: $0.00 CALL FOR INSPECTIONS Call by 3:30 pm for next day inspection,allow 48 hours for Fire Inspections When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon INSPECTION INFORMATION Pass/Fail C 19.PLUMBING FINAL Approved ES-F-LF850L Engineering • - • Job Name Contractor Job Location Approval Engineer Contractor's P.O. No. Approval Representative MasterSeries® LF850 Double Check Valve Assembly 2'/2" - 10" FEBCO MasterSeries LF850 Double Check valve assembly is specifically designed to protect against possible backpressure and backsiphonage conditions for non-health hazard(pollutant) application in accordance with Local Governing Water Utility Code.This assembly is primarily used on potable drinking water systems where Local Governing Code mandates protection from non-potable quality water being pumped or siphoned back into the potable water system. WADVANCED SYSTEM The iron components of the backflow preventer are coated with ArmorTek®.a patented three-part advanced epoxy system engi- neered to reduce microbial-induced corrosion(MIC)and protect exposed metal substrate. LF850 features Lead Free*construction Specification to comply with low lead installation requirements.The assembly The Double Check valve assembly shall be installed on the potable shall comply with state codes and standards,where applicable, water supply and at each point of cross-connection to protect requiring reduced lead content. against possible backpressure and backsiphonage conditions for non-health hazard(pollutant)applications.The assembly shall con- Features sist of a main line valve body composed of two(2)independently • In-line serviceable assembly acting approved clapper style check modules with replaceable • No special tools required for servicing seats and disc rubbers. Servicing of both check modules shall not require any special tools shall be are accessed through inde- • Captured modular spring assembly pendently top entry covers.This assembly shall be fitted with • Reversible and replaceable discs AWWA Compliant inlet/outlet resilient seated shutoff valves;when • Field replaceable seats used on a Fire-Sprinkler application,the assembly shall be fitted • Ductile iron valve body design with UL Classified/FM Approved inlet/outlet resilient seated shutoff • Stainless steel check components valves and contain four(4)properly located resilient seated test • ArmorTek coating technology to resist corrosion of internals cocks as specified by AWWA Standard C510. Iron components • Winterization feature with disc retainers and valve body drain of the backflow preventer shall incorporate ArmorTek coating ports technology, delivering integrated protection against electro- chemical corrosion and microbial-induced corrosion. Flow • Clapper check assembly and pressure loss performance parameters shall meet the • Commonality between 1st and 2nd check components requirements of AWWA Standard C510. The assembly shall be • Captured O-ring design FEBCO MasterSeries LF850. The information contained herein is not intended to replace the full product installation and safety information available or the experience of a trained product installer.You are required to thoroughly read all installation instructions and product safety information before beginning the installation of this product. Inquire with governing authorities for local installation requirements. *The wetted surface of this product contacted by consumable water contains less than 0.25%of lead by weight. FAE FEBCO product specifications in U.S.customary units and metric are approximate and are provided for reference only.For precise measurements, please contact FEBCO Technical Service.FEBCO reserves the right to change or modify product design,construction,specifications,or materials with- out prior notice and without incurring any obligation to make such changes and modifications on FEBCO products previously or subsequently sold. A WATTS Brand Model/Option Approvals - Standards OSY: UL Classified/FM Approved OS&Y Gate Valves • Approved by the Foundation for Cross-Connection Control (ANSI/AWWA C515 Compliant) and Hydraulic Research at The University of Southern Califor- NRS: Non-Rising Stem Gate Valves nia(FCCCHR-USC) (ANSI/AWWA C509 Compliant) • ASSE 1015 Listed LG: Less Shut-off Valves; NOT an approved assembly • UL Classified-(U.S. &Canada) Example Ordering Descriptions • FM Approved* • IAPMO 4" LF850-OSY-Valve Assembly fitted with OS&Y Shutoff Valves . CSA Listed 4" LF850-NRS-Valve Assembly fitted with NRS Shutoff Valves • AWWA Standard C510 Compliant • End Connections: Compliant to ASME B16.1 Class 125& Assembly Flow Orientation AWWA Class D Flange Horizontal&Vertical Up(2'/2"—10")-Approved by FCCCHR- USC,ASSE,cULus, FM, IAPMO,and CSA NO fl95E ` FMNSF G O$ Approved ��. 1015 1364.5 4O Materials Pressure -Temperature Main Valve Body: Ductile iron Grade 65-45-12 Max.Working Pressure: 175 psi(12.1 bar) Coating: ArmorTek powder coating, applied to internal Min.Working Pressure: 10 psi(0.7 bar) and external surfaces Hydrostatic Test Pressure: 350 psi(24.1 bar) Shutoff Valves: NRS resilient wedge gate valves AWWA C509 Hydrostatic Safety Pressure: 700 psi(48.3 bar) (Standard) OSY resilient wedge gate valves AWWA C515 Temperature Range: 33°F—140°F(0.5°C—60°C) (UL Classified/FM Approved) Continuous Check Seats: Stainless steel Disc Holder: Stainless steel Elastomer Disc: Silicone Spring: Stainless steel Clamp: AWWA C606(10"only) Test Cock#4 Test Cock#3 Second Spring First Spring Assembly ssembly Second Check Shutoff Valve#1 1 First Check ® Assembly a Shutoff Valve#2 Assembly 0 0 LP Test Cock#1 Test Cock#2 **Assembly configured with UL Classified/FM Approved OS&Y RW gate valves. Less gate valve assemblies are not UL Classified/FM Approved configurations. Dimensions —Weights Below are the nominal dimensions and physical weights for LF850, sizes 21/2"to 10".Allowances must be made for normal manufacturing tolerances.Visit Watts.com to download the prod- uct manual, or speak with your local FEBCO representative for more information. r i r i I I I I I I I I I I I E*** D** C 11 31 F G SIZE DIMENSIONS WEIGHT**** A B C D** E*** F G NRS OR in. in. mm in. mm in. mm in. mm in. mm in. mm in. mm Ib kg lb kg 21/2 403/4 1035 25'/2 648 10 254 125/8 321 163/8 416 4'/2 114 7'/8 181 226 103 230 104 3 411/ 1064 255/8 651 10 254 12'/8 327 22'/4 565 4'/2 114 73/8 187 252 114 256 116 4 46'/4 1175 28 711 10'/8 257 143/8 365 231/4 591 5'/2 140 8'/8 206 311 141 323 147 6 56 1422 343/4 883 123/4 324 18'/8 479 30Ys 765 6'/2 165 97/8 251 478 217 498 226 8 65 1651 413/4 1061 155/8 397 231/2 597 373/4 959 7 178 111/8 283 781 354 809 367 10 725/8 1845 463/8 1178 155/8 397 271/2 699 48 1219 9 229 123/8 314 1179 535 1217 552 **Indicates nominal dimensions with NRS gate valves. Indicates nominal dimensions with OSY gate valves(full open position). *"`*Indicates weight of complete backflow assemblies with specified gate valves. Performance Flow capacity chart identifies valve performance based upon rated water velocity up to 20 fps. • Maximum service flow rate is determined by maximum rated velocity up to 7.5 fps. • AWWA Manual M-22(Appendix C)recommends that the maximum water Velocity in the services be not more than 10 fps. • UL flow rate is determined by typically rated velocity up to 15 fps. Capacity 21/2"LF850 3" LF850 psi Service Flow Rated Flow *UL Rated Flow psi Service Flow Rated Flow *UL Rated Flow 22 1 1 1 22 20 20 18 18 16 16 14 n i14 o f 12 I I I o c 12 10 YS 10 a 8 8 6 6 4 4 2 I 2 0 0 0 25 50 75 100 125 150 175 200 225 250 275 300 325 350gpm 0 50 100 150 200 250 300 350 400 450 500 gpm 284 566 852 1136 Ipm 379 757 1136 1514 Ipm 7.5 14.7 22.0 fps 7.5 14.5 22.0 fps 4" LF850 6" LF850 psi Service Flow Rated Flow *UL Rated Flow psi Service Flow Rated Flow *UL Rated Flow 18 I I I 18 I I I 16 I I I 16 I I I 14 I I I 1412 12 I I I E o 10 I I I oa 10 I I I 0 o e I I o 0 8 I I I i LL 6 I I I a LL 6 I 4 4 2 2 I I 01 1 1 0 0 100 200 300 400 500 600 700 800gpm 0 200 400 600 800 1000 1200 1400 1600gpm 379 1136 1893 2650 1pm 757 2271 3785 5300 Ipm 7.5 12.8 19.1 fps 7.5 11.4 17.0 fps 8" LF850 10" LF850 Psi Service Flow Rated Flow *UL Rated Flow psi Service Flow Rated Flow "UL Rated Flow 18 18 I I I 16 I I I 16 I I I 14 I I I 14 I I I 12 I I I 12 10 I I I Q 10 I I H p 8 I I I u 0 8 I I I a 6 a LL 6 I I 4 l 4 I I 2 2 0 U 0 400 800 1200 1600 2000 2400 gpm 0 600 1200 1800 2400 3000 3600 gpm 1514 3028 4543 6057 7571 9085 Ipm 2271 4543 6814 9085 11356 13627 Ipm 7.5 10.5 15.3 fps 7.5 9.4 14.1 fps FEBCO A WAM Brand USA: T(800)767-1234•FEBCOonline.com Canada: T(888)208-8927•FEBCOonline.ca Latin America: T(52)55-4122-0138•FEBCOonline.com ES-F-LF850L 2543 0 2025 Watts