20030041.pdfI
DATE RECEIVED [PERMIT EXPIRES
CITY OF EDMONDS Z
CONSTRUCTION PERMIT APPLICATION i
A
OWNER NAME/NAME OF BUSINESS
—, "Asoe sisaL*rPte, A-NLuTie, 6w
15
MAILING ADDRESS
to
I Cob L/JF,:i—( 'D"MA
CITY ZIP TELEPHONE
rz�hmpobS '10 ( 15, T401ZO-776 - 2,>,T4G
NAME
ADDRESS
CITY ZIP ]TELEPHONE
NAME
BL#
Pizo
Cc
ADDRESS
00
CITY ZIP
TELEPHONJ
'5�
STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY
PROPERTY TAX ACCOUNT PARCEL NO.
F
NEW 13 RESIDENTIAL 59 PLUMBIN`It�
ADDITION COMMERCIAL COMPLIANCE OR
11 CHANGE OF USE
REMODEL MULTIFAMILY 13 SIGN
CK REPAIR/galfiftg GRADING FENCE
CYDS ( _x FT)
DEMOLISH TANK OTHER
GARAGE RETAINING WALL FIRE SPRINKLER
CARPORT ROCKERY FIRE ALARM
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
&T"L97T7C_ C4_0 &
NUMBER NUMBER OF CRITICAL
OF DWELLING AREAS
UNITS NUMBER
—STORIES
DESCRIBE WORK TO BE DONE
6 *a- 1,1149" 4±hq&Y:9= OV7-
9F 7, POVr-l-W AIC- VA,4 15
I
S14V1Aj6> mm maw's rL
HEAT SOURCE
GLAZING %
LOT SLOPE %
PLAN CHECK NO'
2,
VESTED DATE
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMrr COVERS WORK TO
I=
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC
D 0 MAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: ISO DAYS
PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLJCANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
2
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. AFUSING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATI90-W3,6ftNCE AND RCW 18.27.
8 URE (OWNER
DAT SIGNED
ISE PERMIT
ONE
NUMBER
OB
SUITE/APT#
DDRESS 160 We-57- -DhqTV-AJ
PLAT NAMEISUBDIVISION NO.
LOT NO.
LID NO.
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved
RW Pertrit Required
Street Use Permit Req'd
EXISTING — PROPOSED
Inspection Required
Sklewalk Requited
REQUIRED DEDICATION— FT
Underground
Winng required 13
METER SIZE
LINE SIZE
OF FIXTURES
PRV REQUIRED
YES 13 NO 13 Le
REMARKS
z
z
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE I
DATE
IRE REVIEWED BY
DATE us
Ir
Iz
VARIANCE OR CU
SHORELINEORADB11
INSPECTION
BOND
13 REO'D
I TKO
POSTED
--
YES
S
SEPA REVIEW
SIGN AREA
HEIGHT
'OMPLETE
EXEMPT
ALLOWED
PROPOSED
ALLOWED
PROPOSED
KP
LOT COVERAGE
REQUIRED SETBACKS (Fr.)
PROPOSED SETBACKS (Fr.)
iLLOWED PROPOSED
FRONT SIDE REAR
FRONT L/RSIDE REAR
z
PARKING
WOOD
IDED
LOT AREA
I P�ANNING REVIEWED BY DATE
I
—
15-
1EMARKS
'HFCKED BY ITYPE cONSTRVn OCCUPANT
1559F-7 GROUP
/0,(-,-
3PECIALINSPEc-noN JAREA OCCUPANT
REQUIRED [] YES LOAD
IEMARKS
IROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REaD
IF,
DescrIpUon
Description
FEE
Plan Check
State Surcharge
Building Permit
City Surcharge
Plumbing
Mechanical
-7n
Grading
Engr. Review
Engr. Inspection
Fire Review
Plan Chk. Deposit
Fire Inspection
Receipt
Landscapeinsp.
Total Amt. Due
Recording Fee
Receipt #
CALL
FOR INSPECTION
11A13
,425)
771-0220
APPLICATION APPROVAL
This application Is not a permit until signed by the
Building Official or histher Deputy: and Foes are paid, and
receipt Is acknowledged in space;xovided.
OZF WCIAGNrA DAT
FELEASE D E
ffTENTION EXT 1333
_L__-Il
tY IS UNLAWFUL TO USEVOCCUPY A BUILDING OR STRUCTURE UNTIL �1_
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAUL",-FEE YELLY-INS
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - ER Go . ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
ALIG-28-2003 10:32
MAYES TESTING ENGINEERS
425 745 1737 P.02/03
MAYESTESTING ENGINEERS, INC.
EMVM 0mor
917-134th Snat SW
I 41M
Sufte A-1
EvemIL WA W204
ph 4U.74UNO
fax 425.74&IrJ7
August 28, 2003
rMum Offl"
lam Srwoma way
Wds E-2
Tacoma, WA ga4N
City of Edmonds Building Department
ph =04-MO
121 Sth Avenue N
fox 25&5ft=7
Edmonds, WA 98020-3146
ANOMW Offim %
7911 NE 3ft Drive
sufte 190
POM&W, OR 07211
AM.: Commercial Inspection
ph SOM811.7516
ftX S=811RO
Re: Harbor Square Athletic Club Permit 2003-0538
160 West Dayton Street
Edmonds, WA
MTE Project No. #E3249
Gentlemen,
This Is to inform you that registered special inspections have been completed for this project as
per our reports, copies of which have been sent you.
TO the best of our knowledge, all work Inspected was either performed In accordance with. or
corrected to conform to, the city approved drawings, or engineer approved changes.
Special inspection was provided for
Epoxy -Grouted Anchors
Expansion Anchors
Field Welding
We trust that this provides you with the information which you require. Should you have any
questions give us a call.
Sincerely,
MAYES TESTING ENGINEERS, INC.
;0
Michael S. Dolder, P.E.
Vice Pros ident
MSD:gsn
cc:Carl Going, Wilcox Construction
RECEIVED
AUG 2 8 2003
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
R K,
4,
. . . . . . . . ...
j,
M
17 `77
MAYESTESTING ENGINEEM""WID.
917-134th St. SW, Suite A-1 Ph 425.74 . 360
Everett, WA 98204 Fax 425.745.1737
10029 S. Tacoma Way, Suite E-2 Ph 253.584.3720
Tacoma, WA 98499 Fax 253.584.3707
7911 NE 33rd Drive, Suite 190 Ph 503.281.7515
Portland, OR 97211 Fax 503.281.7579
INSPECTOR:L I -HRS:—
INSPECTOR: -HRS:
INSPECTOR: HRS:
SITE TIME: TO:--
Page-ot
JOB NUMBER:
DATE: A/
PROJECT:
PERMITCA-""'il�`�-
WEATHER:
OWN: 16(f /e, r ' �e
Apo: 1�4,- "A Ice
ENG: j,-e(-�-ftqONTR:
7--
TYPE OF INSPECTION:
SAMPLES:
dl�
SUMMARY:
V.
-) -11
4
NONCONFORMING CONDITIONSICORRECTIVE ACTION TAKEN:
AUIJ L V
ue� or.1 CIPIAE-14T SF-R"ES
OF EDIAID"I"
Z'
0.
M
M
C
M
8 0
C
M
M
10
C
z
3� '
'56; .1
0 n
�2
M M
r
63
0
C.) R
C (A
z ca,
W
z
z
M
a
NEER
MAYIEWS TESTING ENGZZPj�
917-134th St. SW, Suite A-1 Ph 426. 0*
4 . 737
Everett, WA 98204 Fax 4- _749-143
10029 S. Tacoma Way, Suite E-2 Ph 253.584.3720
Tacoma, WA 98499 Fax 263.584.3707
7911 NE 33rd Drive, Suite 190 Ph 503.281.7515
Portland, OR 97211 Fax 503.281.7579
INSPECTOR: HRS:
INSPECTOR: HRS.
INSPECTOR: — HRS: —
TIME: TO:
Page ----of
A&WA
NU ATE:
JOB NUMBER:
0 B
E
PROJECT:
R 0 J
PERMIT WEATHER:
E R M IT
OWN: C, ARCH:
W
[ENG:
�,CONTR:
TYPE OF INSPECTION:
Typ C
ew f4c'--'
7--
SAMPLES: —
kinmr,nris:nRUING CONDITIONS/CORRECTIVE ACTION TAKEN:
E
0
ES CTR-
I I VY A0 IF: I �Dtmg
---- --- - - --
0
0
M
=PH
65;0�
0 M
C
M
M M
Z
P� :
5(ft
0 -n
M M
9 Vi ,
0 ri
M O�
z
I
65
z
0
4
0
M
I
MAVVC TESTING —ENGINEERS INC.
917-134th St. SW, Suite A-1
Ph 42 01
V.1737
Everett, WA 98204
Fax 425.�-4
10029 S. Tacoma Way, Suite E-2
Ph 253.584.3720
Tacoma, WA 98499
Fax 253.584.3707
7911 NE 33rd Drive, Suite 190 Ph 503.281.7515
7 1 Portland, OR 97211
Fax 503.281.7579
INSPECTOR:
-HRS:
INSPECTOR:
HRS:
INSPECTOR:
TIME: TO:
HRS:
Page_of
JOB NUNiBER:
j,_TATE:
P ROJECT:
PERMIT#:
ViXTHER:
OWN:
ARCH:
E N G:
CONTR:
TYPE OF INSPECTION:
V6 4": fz.v
SAMPLES:
NONCONFORMING CONDITIONS/CORRECTIVE ACTION TAKEN:
RECKIVED
N
AUG 2 8 2W3
DEVELOPMENT SERVICES E; I It
CITY OF EDMONDS
Z..
0
0
M
M
M
.�q. �
0 C
M
0 �
C
OIL
In
M M
17
C
0.
z
0
M
MAYESTESTING ENGINEERSt INC.
August 28, 2003
City of Edmonds Building Department
121 5th Avenue N
Edmonds, WA 98020-3146
Aftn.: Commercial Inspection
Re: Harbor Square Athletic Club
160 West Dayton Street
Edmonds, WA
MTE Project No. #E3249
Gentlemen,
Bull-U1116
S'r-_V - 2 NO3
Permit # 2003-0538
Evaratt Office
917-134th Street SW
Suite A-1
Everett, WA 98204
ph 425.742.9360
fax 425.745.1737
Tacoma Office
10029 S. Tacoma Way
Suite E-2
Tacoma, WA 98499
ph 253.5M.3720
fax 263.584.3707
Portland Office
7911 NE 33rd Drive
Suite 190
Portland, OR 97211
ph 503.281.7515
fax 503.281.7579
This is to inform you that registered special inspections have been completed for this project as
per our reports, copies of which have been sent you.
To the best of our knowledge, all work inspected was either performed in accordance with, or
corrected to conform to, the city approved drawings, or engineer approved changes.
Special inspection was provided for:
Epoxy -Grouted Anchors
Expansion Anchors
Field Welding
We trust that this provides you with the information which you require. Should you have any
questions give us a call.
Sincerely,
MAYES TESTING ENGINEERS, INC.
Michael S. Dolder, P.E.
Vice President
MSD:gsn
cc:Carl Going, Wilcox Construction
.. 11 � . 1 '.., � - ...I,;.
M 7
MM.TION OF BUILDING OMCIALS
STRUCTURALWELDER
X73109 Olympia, WA98507-7310
AW mehod -POBO -6725
Welding Proem SM Manua, 't 41
Phone: (360) 686
rvm: Plate CERTIFIED WELDER CARD
materw: Steel FilleeTypar: F-4A , .1.4,
umis Ranp: 118 &over Joint: G?Oww: nit
A
Bacidins Required for comirkle penduall0e, willds? yes ROBE14T J. HOOVER
50 8373 HOO
Expires: OiJANO4 >
19301 131ST AVE NE
A 98072-8705
Sductural Welder WOODINVILLE W
-auto
FCAW Made
ft"ic Plate positions: rrovirmalm up
e P�
-X IL I WABO
Steel ruwc E71 T This
Ve & cud
If the property 0 Executive Director
166mad on or baton gapimboa date
I*kmu Reap. 118
4�w.* Yes
7P
T W4#
r
WABO Ceirtified Welder January March
Process Qualilications are based on me following standards:
c� S
NAML 7V-19kQ%bIb 03tt-k
SYRUCTURAL WELDING SHEET STEEL WELDING ALUMINUM WELDING
Stindaic No 27-13 WA80 Slandiiia No 271-1.3 WABO Standard No. 28 2 FIRM: (SiPA �`I, COe kALLt
OC Standard No 27- 13 UBC Standard No 2 7.13 UBC Standard No. 28.1
Jupe
-%NSl1-%WS 01 1 2000 ANSIJAWS DI 3.98 ANSUAWS 01.2A.83 April
ANSIPAWS 01 4.98 NAME: Djtc (0-30-03
FIRM:GkeAi\N W6&n,� Titic. J`T%6 Q-
-V�
10
July - September
-1) WELDER
Sl��IJRFIOF CERTIFIL
4E;-KPkt,-L0 eA t Daw P, -30 - C3
.0
I he %igned h.% the cerioned welder) NAN
FIRM:.GkJen1A% L06 Tale ry k b
October - December
Sit;.\ %'I'VRES OF KNIPLOYLKS
m; I,.% rVil �y , Employer/Contivewfi N
&,Age muo i,, Sit AME._ D41C
:N 04�r—lr%§ lk%le It in Me 1.0" Ot 1h1% IA'd dtffl"V the 4uarictly period designaled FIRM: TnIc
afd I, 114A!
p
:rIVED
RECE
AUG 2 8 2003
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
I ktv
�Vv
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ...................
---
FOUNDATION:
Footing......................
Wall........................... .
Pier/Porch .................
etaining Wall ...........
Slab Insulation ...........
PLUMBING:
Underground .............
Roughrin ...................
Commercial Final;..
HEATING:,
GasTest ....................
. 4
Gas Piping ......
Equipment ..............
Commercial Final
E)(TERIOR SHEATHING
NAILING ..........................
FAAMiha ........................
.
FIRST FLOOR FRAMING...
INSULATION ...................
A�
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APP ROVALFOR
OCCUPANCY ..................
M
rg'
ail, �?A
M;
M
r
z
0
In
P"T
C)
M
I
ATE RECEV
RECEIVED
PERMIT EXPIRES
CITY 3F EDMONDS
LISE PERMIT
ZONE -
_-7
< JUMBER
CONSTRUCTION PERMIT APPLICATION
JOB SUITE/APT#
ADDRESS
160 we5T- -DA-qTD)%J
OWNER NAME/NAME OF BUSINESS
Is
PLAT NAME/SUBDIVISION NO.
LOT NO.
LID NO.
MAILING ADDRESS
LID FEE S
160 tj P_ 5-r -DA-f-f7_DM
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved
RW Psm* Required
fWqld
EXISTING
streeill,-Peffn
inspection Required
Sidewatit Required
CITY ZIP IT ELEPHONE
'�01 1-5 MZS�776- S4__-)4G
,PROPOSED
REQUIRED DEDICATION 77 FT
I -
underwound
Wiring required
NAME
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
(3
YES[3 NO E3
I
ADDRESS
REMARKS ' * i
OWNER/CONTRACTOR RESPONSIBLE FOR'EROSION CONTROUDRAINAGE
CITY ZIP
ONE
NAME.
P'Tz C) F= i= Nec AL
jCBL#
ENGINEERING REVIEWED BY DATE
DORE
P
0
L t: x
FIRE REVIEWED BY DATE
W
OM
CITY -ZIP
TELEPHONg
I
0 f
17- 067 / SGI I
MN—D
VARIANCE OR CLI SHORELINE
OR ADBO
INSPECTION
STATE LICENSE NUMBER EXPIRATION DATE CHECK 0 BY
N
I
REO'D
OYES WQ
POSTED
1$
SEPA REVIEW
SIGN AREA
HEIGHT
PROP TAX ACCO PARCEL NO.
COMPLETE EXEMPT
ALLOWED PROPOSED
ALLOWED PROPOSED
EXP
0 NEW
RESIDENTIAL
PLUMBIN4LMECH)
LOT COVERAGE
ALLOWED PROPOSED
REQUIRED SETBACKS (Fr.)
FRONT SIDE REAR
PROPOSED SETBACKS (Fr.)
FRONT LIRSIDE REAR
0 ADDMON
COMMERCIAL
COMPLIANCE OR
0 CHANGE OF USE
I
REMODEL
MULTIFAMILY
SIGN
PARKING LOT
RED PROVIDED
AREA
PLANNING REVIEWED BY DATE
15.
IL
1h
o FENCE
REPAIR /4fLjV_f, GRADING CYDS ( _ X_FT)
REMARKS I
DEMOLISH TANK OTHER
GARAGE RETAINING WALL F RE SPRINKLER
FIRE ALARM
CARPORT ROCKERY
s
M
-(TYPE OF USE. BUSINE88 OR ACTIVITY) EXPLAIN:
PrrHL�e 0-Lo8
CHECKED BY ITYPE
0 MCSTRU
occ UPANT
C 11
GR!!��
NUMBER
OF
NUMBER OF
DWELLING
CRITICAL
AREAS
,
SPECIAL INSPECTION
PANT
LOAD
STORIES
UNITS
NUMBER
JAREA
REQUIRED [] YES
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION RECeD
L,1 KC-: C,0A7J6 7-
7, Ak-
101rim-a-
5MdZf/U&> 1j4GPj!& Z" /A_1Qr)k
VALUATION
HIM 1: U
$
s.ss. W�
Denription
FEE
Description
FEE
Plan Check
State, Surcharge
HEAT SOURCE
GLAZING %
I
LOT SLOPE %
Building Permit
City Surcharge
60 S
PLAN CHECK NO:
2
VESTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK N&ED. THIS Prnmrr COVERS WORK TO
L_.
X
BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: ISO DAYS
PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, [IS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
Landscapelnsp.
Total Amt. Due
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR umrr IN ANY WAY THE cays ABILITY TO ENFORCE ANY ORDINANCE PROVISION"
Recording Fee
Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION
APPROVAL
GIVEN IS CORRE" AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
This application Is not a permit until signed by the
TiON; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
Building Oftlell or his/her Deputy: and Fees are paid, and
IN qIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
receipt Is acknowledged In space provided.
WOPYJfEWS COMPENSAT!���CE AND RCW 18.27.
O�F�.ICIMIGN DAT7,
SpfqTURE (OWNER.411GQE�Oe:�.�
DATE SIGNED
1A0
LIW.404. >7h-r40Vk.__
1 Pz -Z
771-0220
-7
.1 'r
kELEASED/BY D*E
V
rE 10 M 1333
W6CCUPY
_ , i
, , z
" 7;;h / " &
-
IS UNMUL�TO USE A BUILDING OR STRUCTURE UNTIL
is ul�
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORI�1'��q�F - YELL4-_1NSP6CTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK - En - GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
4 , .