20000486.pdf. DATE RECEIVED
LL�!Izl aaw"i�l -
CITY OF EDM6WDS
CONSTRUCTION PERMIT APPLICATION
IER NAMENAMEOF BUSINESS
ZIP I TELEPHONE
2- 0 tl�)
PERMIT EXPIRES
USE PERMIT
200496
ZONE NUMBER
JOB j;F SUIT11-11
ADDRESS
PLAT NAMEISUBDIVISION NO. LOT NO.
LID NO,
_11D ELI I
PUBLIC RIGHT OF WAY PEROFFICIAL STREET MAP
11 Plull l":l`oNl.l o
EXISTING— PROPOSED —
REQUIRED DEDICATION— FT
METER SIZE
LINE SIZE
RE
NO, OF FIXTURES
NO OF "-TU�
IRV RIOUIRED
I
YES 0 NO 0
M TKSTl. RESPONSIBLE FOR EROSION CONTROlLtDRAINAGE
2 RE A S
ft.111— � llP.N EROSION C.NTF
T. 'TOR . SUILE 'OR
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ENGINEERING
REVIEWEDIDATE
ADDRESS
FIRE REVIEWED BY
DATE
VAR_IANCE —OROU
SHORELINEORADBI INSREEQC BOND
TATE DENSE NUMBER
S TATE c
O�ON
RE. .4 POSTED
Y� S NO
E3YES NO
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SERA REVIEW
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[StDGN APREAO EIGHT
E POSED ALLOWE POSED
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PROPERTY TAX ACCOUNT
RANZ. NO.
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LOT COVERAGE
PROPOSED SETBA KS(F
REQUIRED SETBACKS (FTI C FEAFr)
0 NEW
0 RESIDENTIAL
PLUMBING MECH
ALLOWED PROPOSED
FRONT SIDE. REAR FRONT UR SIDE
[3 ADDITION
COMMERCIAL
[LA�PSAI
9
ENT]
COMPLIANCEOR
0 CHANGE OF USE
PARKING
LOT AR E,
I& REMODEL
RTM
[3 APARTMENT
SIGN
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0 REPAIR
FENCE
GRADING CYDS — X — FT)
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DEMOLISH
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GARAGE
FIETAININYG WALL C3 Z.E�WAL�
CARPORT P C
OR ACTIVITYI EXPLAIN:
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TYPE 0, BUSINESS
TION ??E_7
_CHECKSDBY jTYPE,0,�.fDNSTRUC GCCURA
ROUP
DESCRIBE WORK TO BE DONE REMARKS
I PROGRESS INSPECTIONS PER UBC 1081FINAL
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PA"X-- E t)IA— EPPI IUKIIAI ARA
VALUATION I FEE
PLAN CHECK FEE
LOT SLOP' BUILDING
HEATSOURCE DING D
PLAN CHECK NO: PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
NL,, ANY COI UCTION ON THE PUBLIC
BE BONI ON PRIVATE PlOPERTY.0 'ISTR G�DINWFILL
DOMAIN (CURBS. SIDE LKS VEWAY.. NIA, 'BEES, ETC.) WILL REQUIRE
:1 SE�ARATE PERMISSION. STATE SURCHARGE
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PER ISO DAYS
MIT APPLICATION:
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PROVIDED WORK IS STARTED WITHIN 180 DAYS
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ENG. REVIEW FEES
S CKO PINKPESMITFOR MORE INFORMATION
0 'APPLICANT. ON BEHALF 0, HIS OR HER SPOUSE HEIRSEDISIMNS AND SUCCESORS
CITY 01
I N IlTEREST""E' To I N .. MFy. DEFEND ��G NO HARMLESS THE
A 5NTS FROM ANY AND
LANDSCAP
FEE
TS FFI.IAL.. EMPLOYEE
E .. MD.. WA!5.".T.N� RE AFS,�All
I ING DIGRE
INSPECTION
RECEIPT
ALD"", FOR BAMGE OF WHATEVER NATU ,
A MIT ISSUANCE OF THIS PERMIT SMALL NOT BE
PLAN CHECK DEPOSIT
IR.. THE '=FNYC.E OF TH',%'EE
DEEN�G TO WAIVED DUC� ANY REQUIREMENT OF ANY CITY ORDINANCE
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LAU,.
0 M 'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
OF LIMIT INANYWAYTHE CITY
TOTAL AMOUNT DUE
RECEIPT
HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPHUVAL
IHERElY T I
E TH' U
DL�Ly�AGT OT IZE AGENT 0
G H 8 D F
GIVEN IS =TFADN. THAT I AM THE OWN%
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BOTH TME W E ULA INGCONSTRUC -
THEOWNER. IAGFEETOCOMPLyWiTHCITYAN A LA
CALL
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F
TION ED T EREBY. No PERSON WILL BE EMPLOYED
AND'IN DOING THE WORK AUTHORIZ M
RELATING TO
-do,
P.ceiro
FOR INSPECTION
E WASHINGTON
IN V�; OLAT ON 01 THE LABOR CODE OF THE STAT OF
RCW I 11.27�
E DATE
OFFICIALS SIGNATURE
WORKMENS COMPEN SATION INSURANCE AND
_'Em—:7.
DATE SIGNED
(425)
IIG:A,TU�IOWN:�Lj)
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771-0220
REL 0
EXT 333
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ATTENTION
IT IS UNLAWFULTO USE OR OCCUPY A BUILDING 08 STRUCTURE UNTIL
771-0221
FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE YELLOW -INSPECTOR
GOLD - ASSESSOR
A
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER
CITY OF EDMONDS JUN 0 2 2000
SPECIAL INSPECTION AND TESTING AGREEMENT' MAHILUM
ARCHITECTS
The project at J&291CMD 6, "_'J2jZ2J% 504ndL_ issued under building
permit number -requires specifil inslrction �nd/�r testing per UBC Chapter 17
and WAC Amendments 1702. The complete list of specia inspections is attached to this document.
BEFORE A PERMIT CAN BE ISSUED: The owner and contractor and special inspector shall
complete this agreement and the attached structural test(s) and inspections schedule including the
required acknowledgments.
APPROVAL OF SPECIAL INSPECTORS: Each special inspector shall be approved by the
B Idin cial prior to performin% a' d ti 's or 'spcctions. Each special inspector shall submit
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lOfficia'I
Stat ..nt of ualifications to the i2dinu for review. Special inspectors shall display
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(= performin ecial inspections on site. Special inspection and testing shall meet
identification w
ff(C following:
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the minimum requirements of Chapter 17 and the
Dulics Responsibililics Qf the Special Inspector
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1. Observe Work
Th. special inspector shall observe the site work for conformance with the approved
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ped) pl s and spscifications and applicable Workmanship Provisions of the UBC.
c cd s o drawings may be used only as an aid to inspection.
itect or n incer review
Special inspections are to be o on a continuous basis --meaning that the special
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per �d
ins ector is on site at all times o se ing the work requiring special inspection. Periodic
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ns ec i ns, if any, must ave prior a roval by the City based on a separate written plan
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revie d approved y the Buildin Mcial and the engineer or architect of record.
2. Report Non-conformin Items
The special inspector s%all bring nonconforming items to the immediate attention of the
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contractor and note all such items in the daily field report. Any item not resolved in a timel
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manner shall be immediate cause of the special inspector to notify the Building Official of he
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plan deviation, error, change or omission. It shall also be the duty of the special inspector to
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promptly notify the engineer or architect.
3. Complete Daily Reports
Each special inspector shall complete and sign both the special inspection record and the daily
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report form for each day's inspection. These records shall remain at the jobsite with 6
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contractor for review by the City Building Inspector.
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4. Furnish Weekly Reports
The special inspector or inspection agency shall furnish the City with weekly reports of tests
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and inspections. The project engineer or architect, and others as designated shall also be
include following:
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copied on reports. Weckli reports must the
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Descri e locations
y,tion of daily inspections and tests made with applicabl
List o all nonconforming items
Report on status of nonconforming items (resolved or unresolved).
inized ch ges authorized by the Architect, Engineer and City if not included in
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nonconformance items
5. Furnish Final Construction Report
The special inspector or inspection agency shall submit a final sired report to the City stating
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that all items requiring ecial inspection and testing were fulfil ed and reported. And, to the
best of his/her knowle ge th onformance with the approved plans and
e project is in c
approved change orders and the applicable workmanship provisions of the
Wfications,
8 Items not in conformance or unresolved items or any discrepancies in inspection
coverage, (i.e., missed inspections, periodic inspection when continuous inspections were
required, etc.) shall be specifically itemized in this report.
SPECIAL INSPECTION AND TESTING SCHEDULE
kDoms TMN�N—CnONAG��,S��INSPECWR
REINFORCED CONCRETE, GUNITE, GROUT AND MORTAR- STRUCTURAL STEELfWELDING:
Concrete Gunke Grout Mortar IV/A— — Sample and Test (list specific members Wow)
AgliceltneT.-
Rci.fmia. Tens
Mix DesiRm
Rci.f..iag Placement
Bitch Pint Inspection
I.P.,,t Placing
Can Samples
Pkk-�p Samplm
— Shop Material Identification
— Welding inspection OShp 0171,ld
— Ultratmaic Inspection OShp OFeld
— High-suctsitth Bolting
Inspection DShp DIField
0 A325 0 N 0 0
0 A490
— Metal Deck Welding Inspection
— Reinfoming Steel Welding Inspection
— Me,.] Swd Welding Inspection
PRECASTIPRESSTRESSED CONCRETE: — Conercle Insert Welding Inspection
Piks P.61-Te. P—T— Chddqg�
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FIREPROOFING:
— Placement Inspection
— Density Tests
— Thiekness Tests
— Inspect patching
INSULATING CONCRETE:
SampkadTau
— Placement Inspection
— Unit %ights
FILL MATERIAL:
MASONRY: AIIA— — Acceptance Tests
— placement
— Special Inspection Sue,— Used — FWd Density
— Nlitaittary Acceptance Tests (M—ary Umvs. W.11 Pfi,-) STR CTURAL WOOD:
— S.b.q.cm Tests (M.—. Groot. Field Wall Pis—)
— placement Inspection of Units VS., Wall Nailing Inspection ;rAP*A6M)
�.pec.i..orGlu-1a.F.b. %.e
— nspcctionofTrm,;Joi9rxb.
ADDITIONAL INSTRUCTIONS OR OTHER TESTS — Sarnpletod Test C..p—ts
AND INSPECTIONS:
Formcompleted1by:
Telephone No.; !41.v-1 Date:
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MAY-25-2000 10:32 MAYES TESTING ENGINEERS 4257451737 P..02/02
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inspecuff wben W0Tk is ready fiff Wr
the contractor In notify 0r, rp, ato4 on thc aff"'ed
is th a-Uty of AscbeduleAuda"
livtd on the 'Anuht
(cms $hall be
iwp�tion- W-W, 61C. I is, insptctiom, Adrqum ncifi,
bave UPeG
am required to
plans and specificalionS 'al inspector h" time to become bmili- With "u'
so 'bat tbo specl
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,lde A-190 to Applcwcd News the special inspector a"051, to ,Lppumed Plaw ax
2. PFQM ojdjng
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Vie contractor is Tcsporimbic:
the jobsitC,
'i, spocist 1"Spectio ID Records 81 - pecti�m records submitted
3. ?- 1-4 building inSP--
is reapffirAble to retain at ths boitr 41 Pon
It'retke �e to tkw City
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contractor pmrid
by tile gpetial iMcctc`r- These ""As are to
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Work e6&1 in. i'410 approVal Wt be 0 &in9d Prior 10
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of W=I=c include sp9clal Inspectiern requiremmts on the P1 ins and
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a ly the it and vondifid., afthis arvement.
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TOTAL P.02
MAYES
TESTING ENGINEERS, INC. VZSC
Edmonds School District #15
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20420 — 68'h Avenue West
Lynnwood, WA 98036-7400 cl,
PROJECT: SHERWOOD ELEMENTARY
Job #: E0056
Permit #:
Owner: Edmonds SD
Architect:
J Engineer:
Jul. V0 Contractor:
INSPECTION REPORTS
6/21/00
performed nailing inspection of east half of gym roof. Ten -penny at 4" edge and 12" field done
correctly.
To the best of our knowledge, items inspected this date are in accordance with approved plans
and specifications. INSPECTOR: Lisa Pyper
6/26/00
Performed plywood nailing inspection for southeast portion of east roof. Cautioned contractor
about pressure of nail guns, but nailing looks good.
To the best of our knowledge, items inspected this date are in accordance with approved plans
and specifications. INSPECTOR: Lisa Pyper
REVIEWE
-1737
917 - 134th St. S.W,, Suite A-1 Everett, WA 98204 (425) 742-9360 FAX (425) 745
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MAYES
TESTING ENGINEERS, INC.
SHERWOOD ELEMENTARY
Edmonds School District #15 JUL 12 2a
Page 2
PERMIT NO. INSPECTION REPORTS PROJECT E0056
6/20/00
Performed plywood nailing inspection on west half of gym roof. Four -inch perimeter 12" field
nailing with ten -penny x2-1/4" nails.
To the best of our knowledge, items inspected this date are in accordance with approved plans
and specifications.
INSPECTOR: Lisa Pyper
REVIE'WED BY:
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Mark A. Galus' a, P.E.
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FAX (425) 745-1737
917 - 134th St. S.W., Suite A-1 Everett, WA 98204 (425) 742-9360
..�AIAYES
TESTING ENGINEERS, INC. 7
.
SHERWOOD ELEMENTARY DEVELOPMU11'r SERVICES C FR.
Edmonds School District #15 CITY OF MIJ(,:40S
Page 3
PERMIT NO. INSPECTION REPORTS PROJECT E0056
6/27/00
Inspected plywood nailing for northeast comer of main roof All nailing per plans.
To the best of our knowledge, items inspected this date are in accordance with approved plans
and specifications. INSPECTOR: Lisa Pyper
6/28/00
Inspected nailing pattern for 16-foot strip running full length of main roof All nailing per plans.
To the best of our knowledge, items inspected this date are in accordance with approved plans
and specifications. INSPECTOR: Lisa Pyper
7/5/00
Performed plywood diaphragm -ailing inspection for approximately 60 X 140 foot area on
southwest side of mid roof, Nailing in progress. All per plans.
To the best of our knowledge, items inspected this date are in accordance with approved plans
and specifications. INSPECTOR: Lisa Pyper
7/6/00
Performed nailing inspection for roof diaphragm. Cricket was encountered, removed, deck
sheathed, and cricket replaced. All going well. Work in progress on northwest half of east side
of roof.
To the best of our knowledge, items inspected this date are in accordance with approved plans
and specifications. INSPECTOR: Lisa Pyper
REVIEWED BY:
917 - 134th St. S.W., Suite A-1 - Everett, WA 98204 - (425) 742-9360 - FAX (425) 745-1737
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MAYES
SHERWOOD ELEMENTARY TESTING ENGINEERS, INC.
Edmonds School District #15 REC151VED
Page 4 JUL 2 'j 2006
PERMIT NO. INSPECTION REPORTS DEVFP
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7/10/00
Observed plywood nailing ofroofdiaphragm for remainder ofeast roofand small section of O�
north roof Oust south of chimney). Cricket was removed, deck sheathed and new cricket built.
All going well.
To the best of our knowledge, items this date are in accordance with approved plans and -q
specifications.
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INSPECTOR: Lisa Pyper
O�
7/11/00 MI
f, north ofchimney. Concrete deck uncovered so plywood i
Inspected remainder of main roo 10 ,
sheathing taken to edge of concrete. All nailing per plans. >
To the best of our knowledge, items this date are in accordance with approved plans and Vj
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specifications. -n
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INSPECTOR: Lisa Pyper
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REVIEWED BY:
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917 - 134th St. SM., Suite A-1 - Everett, WA 98204 * (425) 742-9360 - FAX (425) 745-1737