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PERMIT EXPIRES
CITY OF EDMONDS
USE ERMIT
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CONSTRUCTION PERMIT APPLICATION
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ADDRESS
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OWNER NAMEINAME OF BUSINESS
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PLAN CHECK NO:
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Plumbing
THIS PERMIT AUTHORIZES ONLY THE WO K NOTED. THIS I ... IT COVERS WORK TO
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t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON a LIC
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SEPARATE PERMISSION.
Engr. REVIEW
PERMITAPPLICATION INDAYS
PERMIT LIMIT, I YEAR -PROVIDE WORK IS STARTED WITHIN 180DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
*APPLICANT ON BEHALF 01 HIS Oil HER 'IOU". HIIIS. ASSIGNS AND IUCCESORS Fire Havie. ;—Iqo
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYE 1, AND AGENTS FROM ANY AND Fire Inspection Receipt #
EARISING
ALL CIAMMS FOR DAMAGES OF WHATEVER NATURE, DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT 8
DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. T I I A t Due
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Recording Fee JRG--7,P,, zol
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM 711E OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
THE OWNE . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC. 11,11 �ppfli I� �.I. p—it -d �Ip,,d by th.
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TION; AND DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED 6111,11�g 01116.1 .1 hi.1h., D. uly; Pd F .. — P.1d, �nd
IN VIOLATION OF THE�U %D�E OF THE STATE 0 WASHINGTON RELATING TO FOR INSPECTION _ pH111k�I1d9PdIP ... PfOvIdIKL
WORKMEN'S CONFINE T,;M,. NCE AND RCW 18.2T
OFFI ITS SIGNATURE oft
DATE SIGNED
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ATTENTION Off 1333 "TY
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
P;NK.OWNER - GOLD -ASSESSOR
OHIGINAL-FILE - YELLOW -INSPECTOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN � ACCOUNTING
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OWNtRiCONTRACTOR IS RESPONSIBLE FOR
EROSION CONTROL AND DRAINAGE
A 2715 Meridian Strect
Belliogham. WA 98225
191MMMERIT ENGINEERING INC. Tde: (360)738-6083
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wwwNeritEngineering.coin
November 18, 2002
Project No. JK0430323
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Steve Nelson
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Estate Homes, Inc.
16300 Mill Creek Blvd.
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Mill Creek, WA 98012
Re: Geotechnical Engineering Investigation
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714 Edmonds Street
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Edmonds, Washington
Dear Steve:
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At your request we have conducted a Geotechnical Engineering Investigation for the above
referenced project. The following report represe nts the results of our field study.
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Thank you for this opportunity to work with you on this project. Please contact us if you have
any questions about this report.
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Sincerely,
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TABLE OF CONTENTS
LETTER OF TRANSMITTAL ................................... I... ................ ............................
7 CERTIFICATE OF ENGINEERING ........................... I ...... I ......................................
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TABLEOF CONTENTS .............................................................................. .... ............. In
1. INTRODUCTION .......................................................... I ................... .........
2. SCOPE .........................
...................................... ...... .............................................
......................................................................
3. SITE INVESTIGATION ...... ............... 2
3.1 Surface Conditions .................................................................. ...................... 2
3.2 Subsurface Conditions ............................................................. .................... 2
3.2 Geologic Background ........................... ; .............. ......................................... 2
3.4 Surface and Ground Water Conditions ................................................... 2
4. CONCLUSIONS AND RECOMMENDATIONS ................................................... 2
4.1 Foundation Design Parameters ................................... ........... ...................... 3
4.2 Seismic Design Parameters ........................................................................... 3
4.3 Foundation Drainage ............. ........................................................ 4
5. GENERAL CONDITIONS ....................................................................................... 4
APPENDIX............................................................................................................... 6
Figure I ........... I .................... ........................................ ; .............. Site Location Map
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Figure2 ........................................................................................ Site Plan
Figure 3 .................................................... " .............. Dynamic Cone Test# I
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Figure 4 ............................................................. Dynamic Cone Test #2
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=Merit Engineering Inc.
1. INTRODUCTION
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Estate Homes, Inc. of Mill Creek, Washington requested Merit Engineering, Inc. to conduct a
geotechnical engineering investigation at the site of a proposed 10' x 30' addition to a single
family residence in Edmonds, Washington. The site is located at 714 Edmonds Street and
bounded to the north, south, east, and west by residential housing. The project area and
vicinity is shown in Figures I and 2 and the locations of the tests in Figure 2a in the
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Appendix.
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The objective of this study was to investigate the subsurface soil conditions at the subject
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property, derive conclusions, and provide geotechnical engineering recommendations for the
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proposed building's foundation design.
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2. SCOPE
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The scope of work for this study included:
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Conduct a visual site reconnaissance.
Conduct 2 Dynamic Cone Penetration (DCPI) tests to maximum depth of 17Y
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where refusal was encountered.
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Perform engineering analysis.
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Prepare this geotechnical engineering report addressing the followings:
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(1) surface conditions,
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(2) subsurface conditions,
(3) surface and groundwater conditions, and
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Recommendations for:
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(4) pipe pile foundation design parameters.
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DCP test consists of driving a 10 cml (1.4- diameter) cone into the ground, The cone is attached to steel rods
and driven by a 35 pound hummer with 15' free fall. Number of blows for each 10 cm (4) penetration was
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�=Mcrit Engineering Inc.
3. SITE INVESTIGATION
3.1 Surface Conditions
The proposed building site is Incated at 714 Edmonds Street in Edmonds, Washington. The
site is relatively flat with a gentle slope up to the east of the site. The majority of the site is
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occupied by a single-family residence — the test area is on the west side of the residence and
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is covered with grass.
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3.2 Subsurface Conditions
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No soil samples were collected during this investigation. We visually observed soft, moist,
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black organic peat at the surface of the site, extending to a depth of approximately two feet.
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This was evidenced by an excavation exposing an electrical conduit. The black peat was also
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found adhering to the penetrating rods of the Dynamic Cone Penetration Device to the depth
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f refusal, when a material of higher density was encountered.
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3.3 Surface and Groundwater Conditions
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We did not observe any surface water or groundwater on the site during our site investigation
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on November 15, 2002.
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3.4 Geologic Background
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The project area is located in the Northern Puget lowlands. This area was invaded by glacial
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ice at least three times during the Pleistocene Epoch, about 1.6 million to 10,000 years ago.
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4. CONCLUSIONS AND RECOMMENDATIONS
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We conclude, based on this investigation, that a pile foundation is required and the site is
suitable for the proposed project from the point of view of geotechnical engineering if the
r mmendations in this report are followed.
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4.1 Foundation Design Parameters
We recommend pile foundation in the area of the proposed addition. 'We recommend 4' steel
pipe driven into refusal for the pile foundation. The refusal depth of driving pipe pile is
approximately 17' to 18'. The allowable capacities of the 4- pipe piles are 15 kips (thousand
pounds) for vertical compression.
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All perimeter footings sho uld be at least 18 inches below the final outside grade for frost
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protection. The base width of the footings shall be between 18 and 24 inches for continuous,
and between 2 and 3 feet for isolated, spread footings.
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The bearing pressure recommended may be increased by X for transient wind or seismic
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loads.
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Assuming construction of the proposed structure is accomplished as recommended above, we
estimate the total and differential settlement of the foundations should be less than Y2^� Most
settlement will occur immediately during construction when loads are applied.
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We recommend that we review those portions of the plans and specifications that pertain to
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earthwork and foundations to ensure that they are consistent with the recommendations in
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this report.
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4.2 Seismic Design Parameters
The project site is located in Seismic Zone 3 according to 1997 UBC (Uniforin Building
Code). UBC maps the United States into 4 seismic zones. Zones I to 4 represent area having
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the least to the most earthquake activities. The soil profile at the site may be defined as S.
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according to 1997 UBC S. represents a soil profile of soft soil with N :5 15. N is b ow count
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number from Standard Penetration Test (SPT2).
2 spT consists ofdriving a split-baffel samplerof 1XID (Inside Diameter) and 2'OD (Outside Diameter) 18-
into ground using a 140 pounds hammer with 30'offree fall. The numberofblows for last one foot of
penetradan t ined as blow count, N which is correlated with the strength limpe es of soil. . ..... .
MMerit Engineering Inc.
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1992 SDCLU (Seattle Department of Construction and Land Usel) recommends that design
criteria for soil bearing capacity consider a one in 100 year seismic event, an earthquake
ground motion that has a 40% probability of exceedance in 50 years. The analysis should be
based on a near crustal event having an assumed magnitude of 6.5 and occurring directly,
below the site. For such an event, SDCLU allows use of a minimum value of horizontal peak
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ground acceleration of 0. 17g (g is acceleration due to gravity) for glacial till soil. This value
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is considered to be reasonable for engineering design at northwest Washington area.
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Therefore, we recommend using a minimum value of, horizontal peak ground acceleration of
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0. 17g for the bedrock at the site.
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Drainage
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4.3 Foundation
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A perimeter drainage system should consist of at least 4 inch diameter, perforated, rigid pipe.
The pipes should be placed along the exterior base of the foundation perimeter and tightlined
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to a storm drain system or a natural drain course. The pipe should be bedded on 2 inches, and
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backfilled with a minimum of 12 inches, of pea gravel. Roof downspouts should be tightlined
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to a storm drain system separately from the footing drains. In addition, the site should be
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graded so that surface water runoff is directed to catch basins that are attached to a storm
sewer drain.
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5. GENERAL CONDITIONS
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The recommendations provided herein are based on our understanding of the project at this
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time and preliminary in nature as the final plan has not been developed yet. We expect the
on -site soil conditions to reflect our findings, however, some variations may occur. Should
soil conditions be encountered that cause concerns and/or are not discussed herein, Merit
Engineering Inc. should be contacted immediately to determine if additional or alternate
recommendations are required.
3 Seattle Department of Construction and Land Use (DCLU), Requirements for Permitting Development in
Critical areas Final Director's Rule 21-92, City ofSeaulc. 1992.
�=MLrit Engineering Inc.
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We recommend that we review those portions of the plans and specifications that pertain to
earthwork and foundations to ensure that they are consistent with the recommendations in
this report. We recommend that we verify site excavation to suitable soil stratum, observe a
proof -roll, verify imported fill materials, and observe and test compaction of structural fill.
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This report is prepared for Estate Homes, Inc. for the specific application to the proposed 10'
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x 30' addition to the single-family residence located at 714 Edmonds Street in Edmonds,
Washington. The project location is shown in Figures I and 2 in the Appendix. This report is
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completed in accordance with generally acce pted geotechnical engineering practices in this
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area. No other warranty, expressed or implied, is made.
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APPENDIX
Subsurface conditions at the site were investigated by conducting 2 Dynamic Cone
Penetration Tests to a maximum depth of 17Y on November 14, 2002.
The locations of the Dynamic Cone Penetration Tests were determined by a representative
from Merit Engineering, Inc. and are shown approximately on the Site Plan (Figure 2a)
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presented in this report. Depths referred to in the test results in this report are relative to the
existing ground surface at the time of the field investigation.
The subsurface condition's description is based on the observations made at the site at the
time of the field investigation. Dynamic Cone Penetration Test results are presented in
Figures I and 2 in this Appendix.
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- IF - T-H--E b6WMtW INTHIS FRAME ISIESS CLEAR THAN THIS NOTICE
�"NOTICE:
IT IS DUE TO THE QUALITY OF THE DOCUM ENT.
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eeunlaa.n� " Queen In ftht of dadada� 0 CoPyAghl 1999 by C,anpaseaulb Micnaearkeling Oat. and Systland Ltd.
PROJECT NO. JK0430323
I PROJECT LOCATION & VICINITY MAP
I DATE:1 1114112
1 Figure I
Gow Residence
714 Edmonds Street
I%j_11-9j MERIT ENGINEERING INC.
Edmonds, WA
2715 Meridian street
Bellingharn, Washington 98225
Telephone: 738-6083
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Fax: 360�738-1499
For: Estate Homes, Inc.
http :, /_..or itEngineering-
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DYNAMIC CONE PENETRATION TEST (DCPT)
SOIL DESCRIPTION AND CLASSIFICATION
DYNAMIC
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RESISTANCE
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Notes:
Results
continued
on next
page.
Project No.JK0430323
StDatell/14102
DYNAMIC CONE TEST #2
Approved by AH
Figure 4a
Elk
Gow Residence
714 Edmonds Street
M—WIMERITENGINEERING INC.
Edmonds, WA
%4111VA2715 Meridian Street
Bellingham, Washington 98225
Telephone: 1 360)738-6083
Fax: (360 1 738-1499
http; //—meritEngineering.com
For: Estate Homes, Inc.
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Notes:
Project No. JK0430323
Test Date 11/14/02
DYNAMIC CONEE TEST #2T1,pr,,,d1,
AH�F4911�14b
Gow Residence
ARM
714 Edmonds Street
T# 1-91 MERIT ENGINEERING INC.
Edmonds, WA
2715 Meridian Street
Bellingham, Washington 98225
Telephone: (360)738-6083
Fax::,,_..,it, (310)738-1499
http Engineering.com
For: Estate Homes, Inc.
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CITY OF EDMONDS
SPECIAL INSPECTION AND TESTING AGREEMENT
-71q rint(lAd,
ssued under build'
The project at i inj
ir�spqction Chapter
permit number —requires special ;yxl/�r testing per LJBC I
to document.
and WAC Amendments 1702. The complete list of special inspections is attached this
BEFORE A PERMIT CAN BE ISSUED: The owner and contractor and special inspector shall
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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
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Building Official prior to performing any duties or.inspection�. Each special inspector shall submit
Statement Qualifications to the Building Official for review. Special inspectors shall display
of
identification whep performin ecial inspections on site. Special inspection and testing shall meet
b9c following:
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the minimum requirements of Chapter 17 and the
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A. Duties and Responsibilities of the Special Inspecto
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1. Observe Work
The special inspector shall observe the site work for conformance with the a
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ay e e n'y
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S ec al n -t-on are to
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s 11 observing the w k requ n special i-spectio n. Periodic
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in - or is on at a t e. in g
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. s ct 0 i any b. t written plan
d 0 s r
in e n in. t ha e p il or ap 0a by the C. se n a epaae
ty
s v �r cord.
ed and a edb h B din d h , en n e a e
rev V " ppry y t g curl an t e gi or rbit ct ofre
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2. Report Non-conformin It ms
The inspector all bring nonconforming items to the immediate attention of the
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special
contractor and note all such items in the daily field report. Any item not resolved in a timely
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manner shall be immediate cause of the special inspector to notify the Building Official of the
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plan deviation error change or omission. It shall also be the duty of the special inspector to
promptly notii� the �ngineer or architect.
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3. Complete Daily Reports
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Each special inspector shall complete and sign both the special inspection record and the daily
report form for each day's inspection. These records shall remain at the jobsite with the
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contractor for review by the City Building Inspector.
4. Furnish Weekly Reports
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The special inspector or inspection agency shall firmish the City with weekly reports of tests
and inspections. The project engineer or architect, and others as designated shall also be
copied on reports. Weekly reports must include the following:
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Dpscn tion ofdaily inspections and tests made with applicable locations
List o all nonconforming items
lRemport oncstatus of nonconforming items (r�solved or.unresolved)
te hanges by the Architect, Engineer City if included in
zed authorized and not
nonconformance items
5.' Furnish Final Construction Report
The sfecial inspector or inspection agency shall submit a final signed report to the City stating
that a. J items requiring sSecial inspection and testing were fulfilled and reported. And, to the
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best of his/her knowle ge the pr ect is conformance with the approved plans and
mcifications, approved change orTers and the applicable workmanship provisions of the
C. Items in discrepancies in inspection
not conformance or unresolved items or any
coverage, (i.e., missed inspections, periodic inspection when continuous inspections were
required, etc.) shall be specifically itemized in this report.
12109/2002 12,17 3607381499 MERIT ENGINEERING IN PAGE 02
426-741-2508 T-075 P-001 F-211
1. NOW tile Special Inspector
to notify the special inspector wben Writ is rc"W for special
It is the ditty ofthO contractor as noted on the approved
inspection. Note, the items listed on the attacbed Wbadult and %equate notice shall be
At
rims and specifications am required to have special inspections.
by the contractor so ftt %be sVedia inspector has time to become falAlisr with the
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provided
project
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So Access to Approved Plans
2. Pmvsl special inspect" access to approved plans at
7he contractor is responsible fbr providing the
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a Special inspection Records -al -
3. Retat ction records submitted
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contractor is responsible to retain at The ' bsit all ec
The Ith."ciTybuiNg b-pector -p-
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by Ilia special i0specrar' Those records are toC, VAdgto
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1. Appi -ova special Inspectors or inspection agencies
builffing departatcAt sball approve all sP-dal inspectors and %Pedal inspection
Ther-
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requirements.
a mud approve wed* reports
2. MODItor spect'd 1119P09001 Special inVectors; shall be
arformamice of
We* M 'a) * action and the Viz/hcr approval must be 6btWnod prior to
$P_W1 Bm.Tid%g inspector.
City
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n ;d
rJUDIT19
monito b the in addition To that Ofthc special inspector-
P laceownto conerett, or other aiihilar kativitie
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3. Issue CcftWc2tt Of Occupancy f occupancy after all weeYN $Pedsl inspection
The Building Official 211WV issue a Cettificato 0
report have be= submitted and accepted.
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The ad owner or the engineer or architect of record acting as the owneeg agent shall ftid
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archited ofrecord shall include special Ins7cutloa =quir=011ft on the plarta-mad ......... .....
The croinec, or
specifications-
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ACKNOwLrDcENMNTS
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I have read and agree g,? comply with the terms and conditions ofthig agreement.
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Dat
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special Inv
GWO-A Contractor
City JI'llding Offid.1
DEC-23-02 I I :58AM FROM -Estate Homes/UBuddlt 425-741-2500 T-131 P 003/006 F-373
2715W-ridian Stmet
BelTiugham, WA 98225
WRIMERIT ENGINEERING INC. Tele (360)738-6093
Fax:: (360)738-1499
N'
www.MeritEngineedng.com
December 23, 2002
Project No. JK0430323
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Mr. Steve Nelson
Estate Homes, Inc.
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16300 Nfill Creek Blvd., Suite 121
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1 $1
Mill Creek, WA 98012
Re: 4- Pile Installation
Gow Residence
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7 14 Edmonds Street
In V
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Edmonds, Washington 98020
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Dear �& Nelson:
me,
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At your request, we have observed the pile installation for the above referenced projecL The
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following report represents our field logs for pile installation.
Table 1. Project Summary
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Number of
Average e
ot
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Piles
Piles
Compression
Length, ft.
Installed Pile,
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Pr oposed
Installed
Piles
9
Sr—
—9
33.4
1 301.0
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The physical parameters of the piles are summarized below:
Table 2. Dimensions & Properties
Outside
Inside
Area I
Yie I
Ultimate
Diameter
Diameter
(in')
Strength (psi)
Strength (psi)
(in.)
(in.)
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4.5
4.026
3.17
48,-PDO
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PYLE INSTALLATION
The locations of the piles are shown on Figure 1. Termination depths for the piles arc listed
in Table 3. The piles were installed on December 21", 2001 The piles are 4' diameter,
hollow steel pipe�s with sectional lengths of 10.5'. A steel coupler connects the sections
together.
The piles were driven into the ground with an 850-pound impact hammer. As the driving
time ofthepile exceeded 16 seconds perinch, the bearing capacity ofthe soil was considered
greater than 40 kips and pile driving was stopped. This driving criterion is based on the pile
contractor's previous experience and previous load test results for the diameter of the piles
MI-laq, .,d ZAVJm-1 Cngin—Ing �d Gaxc�encax S—Ions.
DEC-23-02 I I :58AM FROM -Estate Homes/Nuddit 425-741-2508 T-131 FAWNS F-373
and the size of the impact hammer. The excess portion of the piJes sticking out of the ground
was then ijimmed to the correct length.
Table 3. Termination Depths of Piles
Elie Number
Comments
Total,= Pile
Drivinx slowed at J 6'- 18
3 1.5'
vingsowe at 6171
35.5'
3
Dn'ving slowed at 16':18'
3 1.5,
4
, in, slowed at 20'--22'
§R;VZi;11
50.0'
5 - -
11owed at W-20'
31.5'
6-
]=!ng slowed from then
nued sit A faster rate until 16'
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29.5'
7
n—g-sTo-w-e-ra T 16- 18'
—3T.5—
S
Driving slowed at W-16'
25.5'
9
Vri ing slowed at W-16'. A small spring
was encountered at 12'. Tannic smelling
water flowed from the spring for
!2proximatply 30 seconds.
30.5'
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In general, the soil rondicions encountered at the size during driving were very consisienT.
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Soft black peat and surface water were observed at the surface of the size. A perforated pipe
with a pump inside was located near the middle of the site. The peat typically extended to a
depth of W-20', where harder material was encountered and driving slowed incrementally
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until pile refusal. Obstructions such as possible rocks or bard soil layers that would alter the
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rate of pile driving were, noted (see Table 3, pile number 6), but rarely encountered.
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In addition to observing the pile installation, Merit also observed the installation of top plates
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on the ends of the piles sticking out of the ground. The plates are approximately 6-by 6'
fits into 4- the
' with a coupler that the top of the pile and an approximately srud on
side. The plates are installed by sliding them into the top of the pile. Installation was
observed for seven of the nine piles installed. Installation was not observed for pile numbers
5 and 7, because these piles were trimmed off right at the coupler that connects two lengths
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of piles and required smaller diameter plate fittings that the pile contractor did not bring with
them. The pile contractor informed us that these plates would be supplied and installed on
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12/23/02,
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CONCLUSIONS
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Based on our field observation ofpile installation on December 21" 2002, it our opinion
that the pile installation for The residence; at 714 Edmonds �rreet was completed
satisfactorily, from the point ofview ofgcotechnical engineering.
gMerlt Engineering Inc.
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DEC-23-02 11 :58AM FROM-Es.tate HomeshBuildit 425-741-2508 T-131 F 005/006 F-373
we ap ciate this opportunity to work with you on this project. If you have any questions
abc ri" letter, contact at 738-6093.
please us
Sincerely,
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Austi X Huang, D., R
Principal
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EEMerit Engineering Inc.
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P 003/003 F-367
DEC-23-�02 I I :30AM FROM -Estate Homes/Uuildlt 425-741-2508 T-128
2:5 2 0 0 2 11-S4 AM LANCE
DEC- 10:10AN 428-TAI-1308 T.1?4 P-00?1001 F-111
oe UU I �1 a
McDowell tm pile moo Inc.
pippPILSTOPPI-A le after out off
star (nomirk,51i) pim
installed into Z% 11, 41 or
Use* for ellikyatiOn- are filet Welded to
pending on loads and use And -
in size do
pialoa vOr,
pipe Sleevill eter as reQLijrjid for
alias in diem
pipe 8109ye is S" in Ism9tt" and v
n fti into too of Pipe p"'.
tightly driev g into concreto
ded pile Pems""m
SOSSibility of Op on Of loaded cor0luns-
underfUlW
prevents I grade Uesm
looting or
Ito'
did bY COYQrlflg Open pipe p
potential concrete V
Eliminates
11 Northwest stooms 3 sizes \.Ihiri) fit most. appi"calialls,
pjj*
McDoWel, 4" y. 4- for 2" and 3"
T� 44 which is 319'
-TP68 Wrilch is 112,11, 5", x s,l fcr4" P115 usiri')
-npgB whic), Is 112" 9 6 a 40 OLE
to 1[2"
filet Wald
Example: a 4" Pipe ir,
7 op plate z1gev ia O.D.
he t toy driven *into P"91 slightly
and is t2l, qtweld-A�
crawing top of pipe aromd 0,0
Z, to
pipe plile
.04*
.4ec
tie/
OC VINYL SWAIW
KAY COWAA008 &L
V NO WALLS PIN JPIPFJ FILE %I—K
FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
D. eriLA-i2P7F DATE—a-�I()
ENGINEERING DIVISION
PLANNING DIVISION DATE—
PROJEC
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IS
SITE ADDRESS.
INSPEC
PERMIT ADB# TED
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DESCRIPTION OF WORK TO 13E INSPECTED- QA L--
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A field inspection was conducted to determine final compliance with approved plans. Final approval
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denotes that there are no objections from the above signed Department to the release. of,
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PERFORMANCE BONDS and the granting of:
GRANT FINAL PROJECT APPROVAL
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
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u Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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c3 Copy of CORRECTION NOTICE given to owner/contr actor by inspector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date_ Si
ocaprvi.doc.l:temp:bldg:forrmIO/OI
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
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SETBACKS .............
FOUNDATION:
Footing
Wall
Pter/Potch .................
Retaining Wall ...........
Slab Insulation ..........
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PLUMBING:
Underground
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Rough -hi ...................
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Commercial Final
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HEATING:
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Gas Test ................
Gas Piping ................
—07 . ......
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9-4
3:
Equipment .................
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Commercial Final
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EXTERIOR SHEATHING
NAILING .......................
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FRAMING ....................
FIRST FLOOR FRAMING
INSULATION ................
r Floor Insulation
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Wall Insulation ...........
Calling Insulation
-3 -03
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SHEETROCK NAILING ........... .
SPECIAL INSPECTION
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..............