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A PERMIT EXPIRES
CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLICATION
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REMARKS
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PROGRESS INSPECTIONS PER USC 108/FINAL INSPEC ION REO'D
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Description
FEE
Description
FEE
Plan Check
State Surcharge
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HEAT SOURCE GLAZING
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Building Permit
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City Surcharge
PLAN CHECK NO:
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE ORK NOTEDL THIS PERMIT COVERS WORK TO
t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
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Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEE% ETC.) WILL REQUIRE
t: SEPARATE PERMISSION,
Engr. Review
PERMIT APFUCATION: 164DAYS,
PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 100 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-APPLICANT' N BEHALF OF HIS OR HER SPOUSE� HEIRS, ASSIGNS AND SUCCESORS
Fi,ru Review
Plain Chk. Deposit
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS TON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Recelpt #
MAGES
ALL C - .9'WFA'R`D"AG OF WHATEVER, NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT SSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY
Landscape Insp.
Total Amt. Due
ORDINANCE
0 NOR LIMIT IN ANY WAY THE CRYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Rec rding Fee
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATI
OF
APPLICATION
APPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER, 08 THE DULY AUTHORIZED AGENT
CU
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS HE , LATING CONSTRUC.
CALL
Thi-ppilardwe he net. panall.dfil.lga.d by Una
TIOII� AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE 'CO THE STATE OF WASHINGTON RELATING TO
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Nftn�WORKMENG OMPENS ANC AND RCVV 18.27�
FOR INSPECTION
DWIdIng Official of hledber Dap,dy: and Face are paid. and
rec"PI [a -ckr,,Iodg,d 1, space pra,rdad.
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OFFI UBE DATE
SIG! DATE SIGNED
(425)
�RE�,GWNER
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771-0220
DATE
ATTENTION '
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK -OWNER - GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
4
12- Q-Ce; 2:5oPM;TeY1or Gregory KirtleY C010 ;42S77�7aO 1 3 11 3
UM TAYLOR-GREGORY
L.1;7— AICIIITICTI
Project: Stevens Cath Lab - ArchStruc 654 Sth Ave. South, Suite 300
Project #, , 99391-02 Edmonds, V 98020
Telephone 425.778.1530
Facsimile 425.774.7603
FAX Email infoCtaylorgr0gory.c0o)
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Transmittal
DATE. 1219/2002
MICROFILM
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TO: Mickey Hanson REMARKS:
Construction Manager 0 urgent
Khtley Cole Associates, Inc. 9 For Your Review
1002 10th
Snohomish, WA 98291 0 At Your Request
Phone. (360) 568-3175 0 Reply A$AP
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Fax: (360) 568-7919 0 Other
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FROM: Philip Carpenter
Int Via: D Mail 0 UPS/FedX 0 Hand 0 Messenge r 21 Fax-- Pages sent
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cc: Telephone: Fax:
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Jerry Jacobs an (425) 640-4000
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Date
Pages
Description
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1219/2002
2
DCVR - revised medical suite at Him 109
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Remarks
RECr'.IVED
DEC 13 2002
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
Memo. 122
12- 9-C12; 2:58PM;ToYIor Gregory
KI-ley Col. ;42S7747aO3 21 3
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DCVR Tr6nsm'ittal
MiliII111111 TAYLOR-GREGORY
ARCHITECTS
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654 6th Ave, SOIXh, SUIVI $00
EdMonds,WA 98020
Stevens Cath Lab - ArchStruc
Telephone 425.778.1 SW
Facsimile 425.774.7803
Project Number 99391-02
Email lnfo*taYlot9rQ90TY-CQm
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Joe Crommes
DCVR No: 95
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Advanced Technology Construction Corp.
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4130 Und Ave. SW
Reference: RFl NO 64A
Renton, WA 98055
Phone (425) 251-8483
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Fax: (425) 251-9781
Description:
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Recovery lag Fire Rated Walls
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Philip Carpenter
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Date; 1219/2002
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8PM;Taytor Grcg.,y Klrtley Cole ;12S1747a03 31 a
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P.O. Box 1179
I RTT LLEE Y Snohomish, WA. 98291-1179
&K Phone: (360) 568-3175
Fax. (360) 568-7919
Design, Clarirleation variation Request No.
Advanced Technology Construction
PROJECT: # Stevens Cath-Angio Labs & Chest Pain Center
4130 Lind Ave. SW
PROJECTPH.425609-0443 FAX360568-7919
Renton, WA 98055
Phone: (425) 251-8483
DATE.- 12/09102 Initiated by; ATCC-Joe Crommes
Faxt (425) 251-9781
Total Pages Sent
RF1 NO. 64A
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Contractor Requests clarification or interpretation of Contract Documents ElYes EINo
Contractor requests approval for varl ation from Contract Document 0 Yes rINo
RI Architectural [] Civil [I Electrical [I Mechanical C3 Structural
TED WALLS
Subject; RECOVERY 109 FTRE-:RA Ma I C R 0 F I'L M"
Referenced DrawinglSpec: A2.01
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DESCRIPTION:
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Perjobsite conversation on Friday, 1216/02between our Superintendent and thebuilding Inspectorduring
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the calling cover inspection, the insp eCtor indicated the entailing northeast Well Of RM 109 where sink
in
cabinet is installed as well as the north wall between Dr. 109A and the northeast wall needs to be fire rated.
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Please advise.
Describe How the Owner we Wit benefit from the request Variation. NIA
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Is there any impact on Contract Sum? 0 Yes No 0 To Be Determined
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Is there any imp iect chedide etermined
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OURGENT L7 HIGIIPRIOR177 13 LOWPRIOR17T
PONSE
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At ments; Total Pages Sent:
CCD R ed E]Yes E]No
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CCD Issued
This is not an authorization to proce ed with work invo ving additional costs andlor time. Notiftcation must be
given in accordance with the contract documents ifany response causes any changes to the contract documents.
RF-CEIVED
DEC 13 2002
DEVELOPMENT SeRvIcES CTR.
C OF EDMONDS
ITY
12- 9-02', 3:40PM;TaYlor Gregory Kirti.y C.i. ;�2677,t7803
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REMSED MEDICAL SUITE
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NO SCALE
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DEC 13 2002 TAYLOR-GREGORY
DEVELOPMENT SERVICES CTR�
STEVENS HOSPITAL EDMONDS
W M- ARCHITECTS
CITY OF
CATMANGIO LA13S - CHEST PAIN CENTER
11001"'0' 864 RIM A- Suit- 300
Simot". WA 98020
TGA PROJECT 9939-02
425.778JS30
F_ 426�774.7603
DCVR 95 DEC. 9,2002
JCH-12-2002 12:31 _11AYES TESTING ENGINEERS 4257451737 P.03/05
06/12f2082 11:20� 4252519i� ATC PAGE 02
CiTY OF RJ)MONDS
SPECL4L INSPECTION AND TESTING AGUPIENT
ssued under buildig
permit number uiM special . ection and/or testing per UBC Chapter 17
s
ts 17 2. m ate list ofsp=ixxspcctiops is attached th this document
kudWACAmcn9c.1nkl7 �;c"corll-
BEFORE A PERMT CAN BE ISSUED. The owner and contraclo� and special inspector shall
complete this agreement and The attached etruchiral test(s) and inqecticnis schedule x6cluding the
required acknovdedgments.
AJPPROVAL OF SPECIAL INSPECrORS: FaCh special ins
_pector shall be approved by the
Building Official poor to jimfoomimig any duties or inspections. Ekh special inspector shall submit
Statement of Qualifications to the Building Official for review. Special inspectors awl display
identification whe�l performing _�pecial inspmdons on sitc, Spoial inspection and testing shall meet
the minimum requirements of LIBC Chapter 17 and the fallowft:
A� DQtles 11nd Me special Inspector
1. Observe Work
The special inspector shaHU observe the site work for conformance a approved
'or
ec"d
st p]g mid Ions
ed� b!
sp
f the UBC.
we
am
on.
il-V t R b the special
Y, must p 0, exiodle
approved yth.B .14 written plan
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Re'
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W. an
1tr rs�§ in a timely
cial Of dfa
pl: d
proa not. cotar to
3. ComplateDiflyiteports'
Eacit special m
Vector sball complete,and sign both the sp;�,Qal inspection record and the daily. --
report form. for cach day's inspection. Ilesc records iliall, remain at the jobsit� -with the
utractor f*r review by Me Cit9 Building Inspector.
4. FurniskC WeeMy Re�cru
The pVC6441 iv�pccitor or In-Vaction. j�evry sliall firmish th� City, wiih weekly reports of tests
and inspactioxii, The project engineer o1i arr3lite-61, and othea, ac, desigp
W ihall alga be
U".W ons
copied on ti'm of
R 4t 7"it an onus
ft�ZX if not incinddil in
rJoncont
'45.* Nrnisb Final Constracijon Report
The* mid inspec r orisp tad
them. crtion, CY Shall submit a 6al MiZied,
items requMn 201 P 3=C;1 to the Cit�'d _ng
1,549= . . on !U34 tdstinfi Werik full IT6 n. reported. And, to thic
best of his/her know a -in con or 'th,6 approved plans and
thM
!Iect Is Muct With p
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oikmanship provisioni of the
T RAY-diScrViazies in inspection
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JON-12-2002 12:32 4AYES TESTING ENGINEERS 4257451737 P.04/05
11:10- 42S2SI9*,--' ATC PAGE 03
1. Notify the Special Inspector
is the ditty of4he contractor to notify the special inspector when wo* is ready for Special
inspection. Note, the items listed on the attwhed schedule wd as noted on the approved
plans and Specifications am required to have Special Inspections, Adequate notice Shall be
provided by the contrutor so that the special inspector has ti e to b a familiar w3
in mom th
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2. Provide Access to Approved Plans
7be contractor is responsible for providing the special Inspector accesi to approved plens at
the jobsite.
3. Iketain Special Inspection Records
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The contractor Is responsible let retain at the jobsite all special in Vattion reco b I
rds so in tted
b� the special Inspector. These
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records are to be provided to the Cffy building inspector upon
request-
Pprove sp or Inspection ageliclej
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L Monitor special inspection and approve w-Ady "ports
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Work' re Inesoction and the ectors shali be
caulling SP= f omm of -p ii] IDT
.monitorc by the City B:u din
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placement " concr6to or oth er siffifl4r activities that special inspector.
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3. Issne'Cestiricate oroccupancy
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The -Building Official my issue a Certificate 1
I of O1!CUp,;Ujey #�cr all webkly spei:ial inspection
reports including the fM report have been submitted
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and accepted.
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Ile p!oject o%imer or the eoginet�r or architect of record acting as the ownces agent Shall d
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special Inspection serrices.
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The engineer or architect ofre d aball includo ap�cjal
cpr I inspection re quirements on Hie plow and
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aty Building Offit�
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JUN-12-20022 12:32 MAYES TESTING ENGINEERS 4257451737 P.05/05
06/12/2002 11.10. 4252519-1 ATC PAGE 04
7
SPECLAL INSPECTION AND TEMt4G SCMUL-g
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FINI PROJECT APPROVAL Fk M
TO: -
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: __.YIRE DEPARTMENT DATE_J2-_-:- �-52
ENGINEERING DIVISION DATE—
G DIVISION DATE —
PROJECT CA'1L1\ ALItf,11,,
SITEADDRESS
PERMITk2C) ADB# DATE INSPECTED_L2L_-/(-!� 2
DESCRIPTION OF WORK TO BE INSPECTED_a6jf_&_1_,t�Fr-,' 0--3 d- _;0'
A field inspection was conducted to determine final compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORNIAN X BONDS and the granting of
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
u COPY of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
c3 Copy of CORRECTION NOTICE given to owner/contractorby inspector,
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date_ Si
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall ..........................
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PlarYPorch ......... .......
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Retaining Wall ...........
Slab InsulatIO ..........
PLUMBING:
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Underground .............
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Rough -In
Commercial Final
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HEATING:
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Gas Test ....................
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Gas Piping .............
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Equipment
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Commer6ial Final
ID
EXTERIOR SHEATHING
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NAILING .; ........................
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FRAMING ....................
FIRST FLOOR FRAMING_
INSULATION ...................
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Flow Insulation
Wall Insulation ..........
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Ceiling Insulation
SHEETROCK NAILING
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SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ............. ...