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126928 CITY OF GLENDALE PLANNING&DEVELOPMENT SERVICES 5850 W.GLENDALE AVE..2ND FLOOR GLENDALE.AZ 85301 OWNER/BUILDER ADDENDUM Glendale 623.930.2800 www.GlendaleAZ.com RESIDENTIAL PROJECTS ONLY DATE / �� - COG PERMIT NUMBER /�— 2.0 PROJECT NAME PROJECT ADDRESS C (c O" (L f 4z, 85'3o? The undersigned applicant asserts that she or he is exempt from the original contractor licensing requirement of Arizona Revised Statutes Titel 32.Chapter 10, on the basis of. ❑ ARS 32-1121 A.5 The applicant owns the property and shall occupy the property,and does not intend the property to be for sale or rent.and shall have the work performed by the applicant alone,or by the applicant with employees of the applicant,and/or performed by duly licensed contractor(s)all of whom are identified below or on the attached ['fl ARS 32-1121 A 6 The applicant owns the property and shall have the work performed only by duly licensed contractor(s)all of whom are identified below or on the attached. CONTRACTOR/COMPANY NAME'. AZ ROC NUMBER' LICENSE CLASSIFICATION' r'oaN rot (t7/ NV^S,•► 11707/ ❑ ARS 32-1121 A 7 The applicant is registered architect or engineer,or employee of registered architect or engineer engaged in professional practice,not as a contractor. The undersigned swears and affirms that the information herein is true and accurate,and acknowledges that the filing of an application containing false or incorrect information with the intent to avoid licensing or tax requirements of the State of Arizona is`unsworn falsification'.a cnminal misdemeanor PRINTED NAME OF THE OWNER SIGNATURE OF THE OWNER DATE N CA. N ey2.e d-<<—lOZp CITY OF GLENDALE ADOPTED CODES (WITH AMENDMENTS): 2018 IBC, 2018 IRC, 2018 IECC, 2018 IMC, 2018 IPC, 2018 IFGC GAS LINE DIAGRAM - SITE PLAN Ir *PROJECT NAME N E.T2.d�t ~/ � sw \\J *APPLICANT NAME Ke�✓n'l `rh'r4e.-r `o \ *PHONE NUMBER 40 L-7 57—2.6 6`I EXISTING 2 � K �. GARAGE *PROPERTY ADDRESS t1' 3 ' �'ts}14,t I`^''`t Gte,A le 4 - 15,308 [Cl� i�il w �; . Z D cn Q *NEW PIPE LINE INFORMATION EXISTING EXISTING w �2Z TOTAL LENGTH TO 0-,i'N.—w �i1 ABOVE GROUND EXISTING HOUSE BTU/CFH MOST REMOTE a Z GAS APPLIANCE D BELOW GROUND ..-------j x PIPE BURIED DEPTH= 0 Q w PIPE SIZE TRACER WIRE GAUGE= f—j' a EXISTING PATIO PIPE LENGTH ( y.. BTU/CFH ii TOTAL PIPE LENGTH= ZS GENERAL NOTE SEE EQUIPMENT DATA PLATE [ 1--EFI0 � FOR BTU/CFH INFORMATION APPLIANCE EQUIPMENT BTU/CFH PIPE LENGTH 6—Ip-O-Ip 1 PIPE LENGTH I BTU/CFH PIPE SIZE [ NOTES 1. PLEASE FILL ALL SPACES DESIGNATED WITH TO DESCRIBE PROPOSED SCOPE OF WORK. PIPE SIZE 2 POLYETHYLENE(PE)•OUTDOORS.UNDERGROUND ONLY REQUIRES A YELLOW INSULATED COPPER TRACER WIRE NOT LESS THAN 18 AWG AND THE INSULATION SHALL BE SUITABLE FOR DIRECT BURIAL THE TRACER WIRE SHALL TERMINATE ABOVE GROUND AT EACH END OF THE NON-METALLIC PIPING CONNECTIONS SHALL BE MADE OUTDOORS AND UNDERGROUND BETWEEN METALLIC AND PLASTIC PIPING AND SHALL BE MADE ONLY WITH TRANSITION FITTINGS CONFORMING WITH ASTM D2513(CATEGORY I)OR ASTM F1973. 3 METALLIC SCHEDULE 40 PIPE SHALL BE INSTALLED A MINIMUM 3.5"ABOVE GROUND AND ROOFS. IF INSTALLED BELOW GROUND SHALL BE PROTECTIVELY COATED BY A LISTED COATING APPLICATOR(GALVANIZED PIPE IS NOT AN ACCEPTABLE COATING FOR BELOW GROUND). JOINTS IN PROTECTIVELY COATED PIPE SHALL BE TAPED AND PRIMER SHALL BE APPLIED PER THE TAPE MANUFACTURERS SHEET: INSTALLATION INSTRUCTIONS AND AS PROVIDED IN INSTALLATION STANDARD IAMPO IS 13-2006. 4 4.ALL PIPING SHALL BE BURRIED A MINIMUM OF 12"BELOW GRADE EXCEPT INDIVIDUAL ONES TO OUTSIDE UGHTS.GRILLS,OR OTHER APPLIANCES SHALL BE 8'MINIMUM BELOW GRADE. PROVIDED INSTALLATION IS APPROVED AND IS INSTALLED IN MPI Glendale LOCATIONS NOT SUSCEPTIBLE TO PHYSICAL DAMAGE ARIZONA 5 IF THE GAS PIPING IS TO BE INSTALLED BELOW A BUILDING,AN APPROVED SLEEVE WILL BE REQUIRED-PLEASE ASK FOR CITY OF GLENDALE DETAIL DATE STAMP CITY OF GLENDALE PLANNING&DEVELOPMENT SERVICES 5850 W.GLENDALE AVE..2ND FLOOR GLENDALE.AZ Glendale 623.93 .2800 85301 PERMIT/PLAN REVIEW APPLICATION 623.930.2800 www.GlendaleAZ.cam SINGLE FAMILY RESIDENTIAL DATE COG PROJECT NUMBER. COG PERMIT NUMBER 6 It - La 2,0 /,2 PROJECT NAME PROJECT ADDRESS NE7Z-e- l bLH3 w k r‘ ,7 ! wa-7 1er 4 ( , ,4z ,-3.� PROJECT DESCRIPTION/SCOPE OF WORK- ri_`� Rn/ /I NGh/ 3/ce •• 6, 4 t ✓q.% tea) C. Fr u' 01.%e To K�T Sfio✓G o,✓ Sr, P.- o4 4.4G e*/bse) J4r•c) S7'f 1f fr) w,t�i t/, S1r✓7' PARCEL NUMBER: ZONING DISTRICT' CONSTRUCTION TYPE OCCUPANCY TYPE SUBDIVISION' LOT No FLOOD ZONE (If other than Zone X.plan must be reviewed by the Land Development Engineering) UTILITY COMPANY 0 APS 0 SRP X.SWG SQUARE FOOTAGE. CONSTRUCTION VALUATIOI 17,SQ,r0 APPLICANT NAME/LEGAL AGENT Ill Applicable) Ke4#i1 LQ..A-P,L/ MAIUNG ADDRESS' PHONE NUMBER. 60 Z— 7 f 7_ 46c'f EMAIL ADDRESS. IGLE {&e...,a MQpit Vlq(1 7 �I✓�t`;17 PROPERTY OWNER/BUSINESS NAME I M.i c k AJe-r Z.G MAILING ADDRESS' '2.. `i kr:371 t - ke,,atc , AZ 85-3o8 PHONE NUMBER:6 L j '?i4 — 1,7 7 EMAIL ADDRESS GENERAL CONTRACTOR • r,DO/� ✓q, l(Lr ec�i-+� r 4f MAIUNG ADDRESS u3/ R.0 e, �4 w 16, P P4oett.:v- , AZ. as©SQ PHONE NUMBER:4oz,_Zs3..0 p4) EMAIL ADDRESS P(•p►,3 e r? /h19A/ VAtlt/ I/✓,.'•6,4)' AZ ROC NUMBER:19 7 p 7 7 LICENSE CLASSIFICATION COG SALES TAX LICENSE No PERMIT/PLAN TYPE(Check all that apply). REVISION TO APPROVED PLAN: 0 YES ❑ NO SINGLE-FAMILY 0 NEW SFR 0 REMODEL 0 LIVABLE ADDITION 0 NON-LIVABLE ADDITION 0 CARPORT ❑ GARAGE 0 ENCLOSURE 0 ACCESSORY STRUCTURE 0 ABATEMENT PROPERTY No. 0 STRUCTURAL REPAIRS ❑ FENCE/SCREEN WALLS ❑ RETAINING WALLS ❑ PRE-MANUFACTURED HOME OTHER. 0 DEFERRED SUBMITTAL 0 FIELD REVISIONS ❑ ELECTRICAL *GAS 0 I(the undersigned)understand and agree that the issuance of the permit for which I am applying does not relieve me of the responsibility that this work will be done in conformity with the laws of the City of Glendale.Maricopa County and the State of Arizona I further agree that the City of Glendale Development Service Department has the authority to engorce adopted building codes and regulations not indicated on the construction documents SIGNATU DATE /, ``—& LO PERMIT FEE.