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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME.AME OF BUSINESS
Voice Stream I.-ireless
MAILING A DRESS
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CITY Zip
48 -
1 ITEL PHONE
3othell 01
NAME
wood Crppk ouisness Parl'
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Wooeinville 98072 42 , 415-0746
NAME
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USE PERMIT
70NE NUMBER :20()Z74
JOB SUITEIAPTO
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PLAT NAMEISUBDIVISION NO.
LOT NO.
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LID FEE S
PUBLIC 13IGHT OF WAY PEA OFFICIAL SI FEET MAP
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REMARKS
A=NTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
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DATE
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ALLOWED PROPOSED
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FRONT SIDE REAR
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ADDITION
COMMERCIAL
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(TYPE OF USE. BUSINESS ;R ACT11 ITY) EXPLAIN:
CHECKEDBY TYPE OF CONSTRUCTION
OClUlANT
.. Up
NUMBER
OF
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NUMBER OF
DWELLING
UNITS 0
GH.
GH.
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NUMBER 0
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SPECIAL INSPECTOR
REQUIRED C3 YES
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JAH LOAD
DESCRIBE WORK TO BE DONE
* x
� - - - , --'a
REMARKS
Qq INAPIEMIONS PER UBC 1081IFINAL INSPECTION RECI'D
O� a three sector antenna array with
Hilt ina op�houg, of an enistiaCT
L ansm,_�!er
b.ildinq w3- mitter
th rae.. '
P"13i pment-0 ,,,!r
the same roof.
PLAN CHECK FEE
1,1j.-T�...GFICE G-ZIN071---,
LOT SLOPE I
BUILDING
PLAN CHECK ND:
PLUMBING
MECHANICAL
t:
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS Y`oRKTl
BE DONE ON .,VAT PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS. SIDZWALIU5, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
GRADINGIFILL
c4l SURCHARGE
F
I IF
I
T
PERMITAPPLICATI-W Hl-IDAY-
PERMIT LIMIT'. I YEAR, PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENG. REVIEW FEES
;A PLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUC ES RS
P -S TO INDEMNIN HARMLESS THE CITY OF
N ;,y4L".FND AYN�D H.oL.. AGENTS FROM ANY AND
2 ECINTEREST. AGREE . EVIL. ES A
MONDE WASHINGTON. ITS OFFK
A FOR DANA6ES OF WHATEVER NATURE. ARISING DIRECTLYOR INDIRECT'
LL CLAIMS 'S... E . U P IT SHALL NOT BE
FROM I.E WA,VT"Il PERMIT 15S AICE OF THIS IFY
TOMODIFY, E OR REOU ANY REQU REMENT OF ANY CITY ORDINANCE -
DEEMED C' I'
NOR L IMIT IN ANY WAY THE CITY'S ABILITY To EN FORCE ANY ORDINANCE PROVISION
ENG. INSPECTION FEE
_L�NDSCAIING
INSPECTION FEE
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
riNNSPECTII
I HTHFITY ACKNOWLEDGE T, AV 5 Ap,,L�CAToN� THAT THE INFORMATION
11AT: " THREDAa T'�' PT OR , E DUL AUT14ORIZED AGENT OF
GIVEN IS CORRECT. AND T1 AT AM e WN
THEOWNER I A"EE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION. AND III POING THE WORK AUlHORtZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLAIION OF THE LABOR CODE Or THE STATE OF WASHINGTON ABLATING 10
WORKMEN � COMPENSATION INSURANCE AN. P111 111,11
LL
CALL
0 1 S P CTI,
FOR
(425)
771-0220
ATTENTION
EXT 333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI� 771-0221
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX
�IRS
APPLICATION APPROVAL
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pan F.
M�IYL,
ORIGINAL FILE YELLOW INSPECTOR
PINK. OWNER GOLD ASSESSOR
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A RA
ENGINEERING GLOBAL SOILTIONS
AGRA Earth &
Environnnantal, Inc.
11336 NE 122nd Way
Suite 100
Kirkland' Washington
USA 98034-69`18
Tel (425) 820-4669
Fax (426) 821-3914
May 2. 2000
0-91M-13323-C
Wren Construction Inc.
1108 Rucker Avenue
Everett, Washington 98201
Attention: Mr. Randy Bonsen
Subject: Final Summary of Special Inspections
Voice Stream Wireless - Stevens Hospital
21601 — 76" Avenue W.
Edmonds, Washington
City of Edmunds Building Permit: 2002274
Dear Mr. Bonsen:
AGRA Earth & Environmental, Inc. (AGRA) respectfully submits this final Summary of special
inspection services for the referenced project. Our services were performed as requested and
scheduled by Wren Construction Inc. Daily Field Reports of our inspection were prepared at the
time our services were provided. our Daily Field Reports, which are attached, form the basis for
this final summary letter.
AGRA performed special inspection services for the installation of four epoxy anchors. The
installation was as per manufacturer's (Hilti) recommendations.
MICROFILM
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AGRA
A AGRA
ENGINEERING GLOB�L SOLUTIONI
11335 N.E. 122m Way, Suite 100 Tel (425 820-4669
5 )
Kirkland, Washington 98034 Fax (42 ) 821-3914
1E
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111E1
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DAILY FIELD REPORT
FROJECTNO..
9- -13 3 - C
AEPOATNO.
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DATE
OF
A MN 0.
C21
SE EMAG NO.
,,ZEPRESE
Ce" -
S PLES OBTAINED (NOMMITYPE)
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SU E�R���
To the bes of our knowledge, all items inspected as noted above were 12-71--s 0 �P'eliminary Observations�
in general toonformance with the approved plans and specificati 0 No 0 Deficiency corrected - Report No.
A RAFIELDREPR NTATIV�E�����
THIS REPORT IS CONSIDERED PRELIMINARY AND SUBJECT TO CHANGE PENDING RFVIFW Idy Uum ---- -
This report is provided solely for the information of our client. This report is not intended to be transmitted to a third party by any means. except in full,
without written permission of AGRA Earth and Environmental, Inc. I
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FINAL PROJECT APPROVAL IEORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: DEPARTMENT DATE
NGDIVISIOND
DIVISIOND
SITEADDRESS �a"U t(6) / I,( —
'? 2!�- ADB#A%WAATE INSPECT
PERMIT g__, L
DESCRIPTION OF WORK TO BE INSPECT
A field inspection was conducted to determine compliance with approved plans. Final approval denotes that
there are no objections from the above signed Department to the granting of:
_-'—'Final approval of the described work
Bonds associated with the project may be released
,—'--_GRANT FINAL PROJECT APPROVAL
FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
RECE:J,tf2:E)
1. MAY 19 2000
___yAILED FINAL INSPECTION -OUTSTANDING ISSUES DEVEI.OPMrNFSE'IV1Cr--SCTR
- CITY OF EDh1WJfi
I
2.
3.
_______p,E-INSPECTFD OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
ocaprvl.doc.l:tcmp:bldg:fomis6/98
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CITY OFEDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMENAME OF BUSINESS
voice Stre.- Wi —1 --q
G ES
MAILINGADDRIESS
19,807 North Creok Parkway N
C C�
ITY .11 TELEPHONE
.1
Bothell 98011 1(425)829-0061
NAME1' ,
USE
ZONE
PERMIT
NUMBER
JOB
ADDRESS.
SUITVAPTR
PLAY NAMEISUBDIVISION NO.
LOT N9.
LID NO.
D
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
IE-P
RA �K A.q-d
P.- `I.�
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EXISTING PROPOSED
REQUIRED DEDICATION FT
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W'
-!-E!E�3 �140
LINE SIZE
NO�OF 1IXTT..
REQUIRED
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CITY
ONE
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Woodinville. 9z8'PO 7 2
ITELEP
(42.5)415-0746
NAME DIDATE
ENGINFEFI.G
ADDRII
FIRE REVIEWGD By DATE
JCITY ZIP TELEPHONE I .. q
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. CT'O- SON.
-,SHOREL�Ne,OR INSPE.
tj i
VARIANCE OR CU ADBI
RE POSTED
STATE LICENSE NUMBER EXPIRATION D.AT� C
IW-YES 13NO
SEPA REVIEW SIGN AREA HEIGHT
COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
ROPERTY TAX ACCO�NT
p,ROPERTY TAX ACCO�NT
,ROPERTY TAX ACCO�NT
5507 - 000 0-7 -1 -05 Oj? EXP
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (17.)
C] NEW PLUMBING I MECH ALLOWED PROPOSED FRONT SIDE , REAR FRONT URSIDE REAR
COMPLIANO OR
ADDITION CHANGE05EUSE
--
1,101113 IT Al DATE
C3 SIGN
'D PROVE!
h.,
0 REMODEL
F
0 REPAIR I X FT) REMARKS "I
0 HER
0 DEMOLISH ;,0. TANK Cir T(
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CGARAGE RETAIN WALL RENEWAL H C. P
A1 CARPORT AGOXEV (I L-D) H6 I"OL- 0 IZ
0
AC IVITY) EXPLAIN: OCCUR
ITYPE OF USE� BUSINESS OR T N.11FRUCTION ANT
CHECKEDBY ITYPSOI..
P
NUMBER NUMSERO CRITICAL
DWELLING AREAS
9_"
JAIIA OCCUPANT
0" LOAD
OF, N 0
STORIES UMBER
RED y
REOU ES
DESCRIBE WORK TO BE DO E
REMARKS
ret PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REO'Dj
-7
5:iyj-.k rTLAA aQ_ rr, �cn
of a three sectoraantenna. array with
0
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la� p— 5et;
existin eni-houp. of an R n
building with radio transmitter
the same, roof
VALUATION FEE
PLAN CHECK FEE
LOT SLOPE %
BUILDING
N/A
PLAN C4ECK NO: r' VESTED DATE
PLUMBING
(.b.)-
MECHANICAL
H PERMIT COVERS WORK 10
THIS PERMIT AUTPORIZES ONLY THE WORK ND'E6,N' R C`TIONON THE PUBLIC
BEDONEON RIVATE PROPERTY ONL . Ay . I U U
IRE
IRE
GRADINGIFILL
R LKS. DRIVEWAYS. MAROUEES. ETC.)WILLREQ
DOMAIN (CU SS SIDEWA
SEPARATE PERMISSION..
Vv SURCHARGE
R IT APPLICATION4 IN DAYS
I AR- PROVIDED WORK IS STARTED WITHIN 160 DAYS
��X M
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ON BEHALF OF HIS OR HER SPOUSE HEIRSLASSIONS AND SUCCESORS
5NG. INSPECTION FEE
;APPLICANT.
FY DEFEND jN HO D HARMLESS THE CITY OF
D
N INTEREST. AD ANYAND
ED FEES TO NDE=C SFROM
ONQ�, WA ........ ;T. OFF IAL�. EMPLOYEES. AND AGENT
LANDSCAPING
INSPECTION FEE
MADE. OFWHATEVER NATURE. ARISING DIRECT-0 RINDIRECTLY
A-.LAIM. F-F-A S NO ERMIT SHALL NOT BE
S
OF THIS P=ANYUAE.UER
IRECEIPT
PLAN CHECK DEPOSIT
I -'T.
F ISSUANCE
ROM THE
M NTS-FANY ORDINANC
EEMEDTOMODI YWAIVEORRE CIIVPROVISIONE
FWAYTHECITY'SA
OR
NORLIMITINANY RILITY TO ENFORCE ANY DINANCE
x
TOTAL AMOUNT DUE
READ
T,.C�A,.L�� THAT THE INFORMATION
I HERESY LE OG I G,
-AITEH AGENT OF
APPLICATION A PPROVAL
E VT.,A
TT.HAAT:
.=T.A,. A. V NER. AUTHORIZED
GIVEN S REGULATING CONSTRUG,
TO COMPLY WITH CITY AN6 STATE LAW
T IN., D-17 ,d F111 IM Plid. a.d
CALL ..ml,
THEOWNEW I AGREE
11ON: AND IN DOING THE WORK AUTHORIZED THEREBY. NO PEFIS0,N WILL BE LEMPLOYED
CODE OF THE STATE OF WASH[ DION RE ATING TO
FOR INSPECTION no jpj i, ack—I d odi—P—p—d.d.
IN VIOLATION OF THE LABOR
WORKMEN'$ COMPENSATION INSURANCE AND RCW 18.27.
OFFICI L IGNATUR
SIGNATUREJOWNER OR AGENT) SIGNED
(425)
JDATE
771-0220 11 AS By DATE
EXT 333
A17ENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING 08 STRUCTURE UNTIL
771-0221 INSPECTOR
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL FILE YELLOW
GOLD -ASSESSOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
5198
FAX PINK -OWNER
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