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DATE JECE ED ERMIT EXPIRE
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CITY OF EDMONDS NUMBER
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ADDRESS
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: 180DAYS
PERMIT LIMIT., 1 YEAR - PROVIDED WORK IS STARTED WITHIN 100 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
U) 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review PlanChk.Deposit I f.
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF '3�X�
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
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ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING 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 Landscapelnsp. Total Amt. Due -7 L
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
Xi Recording Fee Receipt
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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 APPLICATION APPROVAL
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 Official or his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18,27. nfATE
OFFICIALS SIGVATURE 00r,
SIGNATURE (OWN5R C,R GENT) DATE SIGNED (425) 1eAA:4f__) /A /) A�r
/1) &�Tl ?11 1 W J / ; /L
771-0220 /RrT_9f D DATE
ATTENTION EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
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A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELL6W -I SPEC OR
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CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - *ASESSOR
04,,02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING
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TERRA ASSOCIATES, Inc.
C011SUIM111S hi Geotecliiiical Digineerkig, Geology
alld
Divit-oniiietital Eaali Scieiices
RIECEIVEE)
DEC 10 2003
PERMIT COUNTER
Mr. Scott Catton
736 Dayton Street
Edmonds, Washington 98020
Subject: Geotechnical Evaluation
Catton Residence Addition
8729 Main Street
Edmonds, Washington
Dear Mr. Catton:
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December 5, 2003
Project No. T-5480
As requested, we evaluated geotechnical conditions at the subject property. The purpose of our study was to
address City of Edmonds Permit Submittal Requirements, specifically, classification of the site soils and
determination of soil bearing capacity.
The proposed project will consist of constructing an addition to the northern side of the existing residence.
Based on our conversation with you, we understand that the addition will be a wood -frame garage with a concrete
slab -on -grade floor. The upper level of the addition will be living area.
SITE CONDITIONS
Surface
The site is a residential lot in Edmonds, Washington. The location of the site is shown on the attached Vicinity
Map, Figure 1. Site grades in the area of the addition are relatively flat with a gentle grade down to the east-
northeast. Topographic information provided by you indicates grades in the area of the addition are about 6 to 7
percent. Vegetation in the area of the proposed addition consists predominantly of grass. We observed a
concrete slab in the northern portion of the lot, near the northern margin of the addition. It appeared that the slab
might have been the floor of a previous garage.
12525 Willows [�Oad, SUite 101, Kirkland, Washington 98034
Phone (425) 821-7777 a Fax (425) 821-4334
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Mr. Scott Catton
December 5, 2003
Subsurface
We investigated subsurface conditions in the area of the addition by excavating two backhoc test pits to
maximum depths of approximately eight and ten feet below the ground surface. A geological engineer from our
office conducted the field exploration, maintained a log of each test pit, classified the soils encountered, collected
representative soil samples, and observed pertinent site features. All soil samples were visually classified in
accordance with the Unified Soil Classification System (USCS) described on Figure 3.
In general, the soils we observed in the test pits consist of ten to 12 inches of topsoil overlying loo se to medium
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dense silty sand with gravel to depths of about three to 4.5 feet. These upper soils are underlain by glacial till
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consisting of dense to very dense sand with silt and gravel to silty sand with gravel to the test pit termination
depths.
The Geologic Allap of the Edmonds East and part of the Edmonds TVest Quadrangles, Washington, by James P.
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Minard (1983), shows soils in the area of the subject site mapped as Vashon glacial till. This is consistent with
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the soils we observed at depth in the test pits.
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We did not observe groundwater seepage in the test pits. However, we expect that a seasonal perched water table
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develops on the relatively impermeable glacial till at times during the wet winter season. Perched groundwater
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levels and flow rates will fluctuate seasona Ily and typically reach their highest levels during the wet winter
months (October through May).
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Detailed descriptions of the subsurface conditions encountered are presented on the attached Test Pit Logs,
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Figure 4. The approximate locations of the test pits are shown on Figure 2.
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DISCUSSION AND RECOMMENDATIONS
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In our opinion, the native, medium dense to very dense soils observed beneath the surficial topsoil layer are
suitable for supporting the residential building loads. W e observed loose soils between approximately 1 and 3
feet in Test Pit TP-2. Because of lateral variations in the relative density of the native soil in the area of the
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proposed addition, exposed subgrades that will provide support for foundations.or floor slabs should be examined
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to verify a relatively firm condition. If loose subgrade soils are observed, they should be mechanically
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compacted in -place to provide a uniform bearing surface.
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The native soils contain a sufficient amount of fines that will make them difficult to compact when wet. The
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ability to adequately compact the site soils will depend on the soil's moisture content and the prevailing weather
conditions at the time of construction. If foundation subgrade soils can -not be compacted in -place to a relatively
firm condition due to excessive moisture, the wet soils should be removed to a firm bearing surface.
Alternatively, overexcavated footing areas may be returned to grade with structural fill.
Structural fill should be placed in uniform loose layers not exceeding 12 inches and compacted to a minimum of
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95 percent of th e soil's maximum dry density, as determined by American Society for Testing and Materials
(ASTM) Test Designation D-698 (Standard Proctor). The moisture content of the soil at the time of compaction
should be within two percent of its optimum, as determined by this ASTM standard.
Project No. T-5480
Page No. 2
Mr. Scott Catton
December 5, 2003
Foundations
The proposed addition may be supported on conventional spread footifig foundations bearing on an adequately
prepared subgrade of firm native soil or structural fill. Perimeter foundations exposed to the weather should bear
at a minimum depth of 1.5 feet below final exterior grades for frost protection. Interior foundations can be
constructed at any convenient depth.
We recommend designing foundations for a net allowable bearing capacity of 2,000 pounds per square foot (pso.
For short-term loads, such as wind and seismic, a one-third increase in this allowable capacity can be used, With
the anticipated loads and this bearing stress applied, building settlements should be less than one-half inch.
For designing foundations to resist lateral loads, a base friction coefficient of 0.35 can be used. Passive earth
pressures acting on the sides of the footings can also be considered. We recommend calculating this lateral
resistance using an equivalent fluid weight of 350 pounds per cubic foot (pcf). We recommend not including the
upper 12 inches of soil in this computation because it can be affected by weather or disturbed by future grading
activity. This value assumes the foundation will be constructed neat against competent soil or backfilled with
structural fill. The friction and passive values recommended include a safety factor of 1.5.
Drainage
Surface
Final exterior grades should promote free and positive drainage away from the building areas. We recommend
providing a gradient of at least three percent for a minimum distance of ten feet from the building perimeter,
except in paved locations. In paved locations, a minimum gradient of one percent should be provided, unless
provisions are included for collection and disposal of surface water adjacent to the structure.
Subsurface
We recommend installing continuous drains along the outside lower edge of the perimeter building foundations.
The foundation drains should be tightlined to an approved point of controlled discharge independent of the roof
drain system. Subsurface drains must be laid with a gradient sufficient to promote positive flow to the point of
discharge. All drains should be provided with cleanouts at easily accessible locations. These cleanouts should
be serviced at least once every year,
LUNUTATIONS
-inical engineering practices. No oth r
We prepared this report in accordance with generally accepted geotecl e
warranty, expressed or implied, is made. This report is the copyrighted property of Terra Associates, Inc., and is
intended for specific application to the Westfield project in Snohomish County, Washington. This report is for
the exclusive use of Stafford Homes and their authorized representatives.
Project No. T-5480
Page No. 3
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Mr. Scott Catton
December 5, 2003
The analyses and preliminary recommendations presented in this report are based on data obtained from the on -
site test pits. Variations in soil conditions can occur, the nature and extent of which may not become evident
until construction. If variations appear evident, Terra Associates, Inc. should be requested to re-evaluate the
recommendations in this report prior to proceeding with construction.
We trust this information is sufficient for your current needs. If you have any questions or require additional
information, please call.
Sincerely yours,
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REFERENCE: Thomas Guide, CD-ROM , King/Pierce/Snohomish Counties, 2003 NOT TO SCALE
Terra VICINITY MAP
CATTON RESIDENCE ADDITION
Associates, Inc. EDMONDS, WASHINGTON
Consultants in Geotechnical Engineering
Geology and Proj. No. T-5480 Date DEC 2003 Figure
Environmental Earth Sciences I 1 1
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REFERENCE:SITE PLAN PROVIDED BY CLIENT APPROXIMATE SCALE IN FEET
Terra EXPLORATION LOCATION PLAN
CATTON RESIDENCE ADDITION
Associates, Inc. EDMONDS, WASHINGTON
Consultants in Geotechnical Engineering
Geology and Proj. No. T-5480 I Date DEC 2003 Figure 2
Environmental Earth Sciences
MAJOR DIVISIONS
LETTER
SYMBOL
TYPICAL DESCRIPTION
Clean
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GRAVELS Gravels
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fines.
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Silty sands, sand -silt mixtures, non -plastic fines.
0
smaller than Sands
—1
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SIC
Clayey sands, sand -clay mixtures, plastic fines.
ML
Inorganic silts, rock flour, clayey silts with slight
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SILTS AND CLAY S
plasticity.
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HIGHLY ORGANIC SOILS
PT
Peat.
DEFINITION OF TERMS AND SYMBOLS
U)
Standard Penetration
2" OUTSIDE DIAMETER SPLIT
U)
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Density Resistance in Blows/Foot
T]
SPOON SAMPLER
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30-50
7- WATER LEVEL (DATE)
0
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Tr TORVANE READINGS, tsf
Standard Penetration
Pp PENETROMETER READING, tsf
Consistency Resistance in Blows/Foot
DD DRY DENSITY, pounds per cubic foot
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LL LIQUID LIMIT, percent
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Medium stiff 4-8
pi PLASTIC INDEX
0
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N STANDARD PENETRATION, blows per foot
Very stiff 16-32
Hard >32
Terra
UNIFIED SOIL CLASSIFICATION SYSTEM
E ADDI N
CATTON RESIDENCE ADDITION
DEN
I C TIOJF
Associates, Inc.
;H NG ON
EDMONDS, WASHINGTON
S WA
;DateDEC
Consultants in Geotechnical Engineering
Geology and
Environmental Earth Sciences
igu
2003 ure 3
Proj. No. T-5480 � t C 00
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Test Pit No. TP-1
Logged by: JV
Date: 12/1/03
Depth
Approximate Elev. 100
Moisture
Content
(ft.) Soil Description N
0 TOPSOIL with debris (trash and roof shingles)
Reddish -brown silty SAND with gravel, medium dense, moist. (SM) With roots.
Gray silty SAND with gravel, dense to very dense, moist. (SIVI) (GI cial Till)
10 Test pit terminated at 10 feet.
No groundwater seepage observed.
15
Test Pit No. TP-2
Logged by: JV Approximate Elev. 102
Date: 12/1/03
Moisture
Depth Content
(ft.) Soil Description N
0 1 10 inches TOPSOIL.
Reddish -brown silty SAND with gravel, loose, moist. (SIVI)
Gra SAND with gra fl, fine grained, dense, moist. (SP)
5 acial Till)
Gray SI,
Gray silty SAND with gravel, dense to very dense, moist. (SM) (GI
10 j Test pit terminated at 8 feet.
to groundwater seepage observed.
15
Terra TEST PIT LOGS
CATTON RESIDENCE ADDITION
E
Associates, Inc. EDMONDS, WASHINGTON
Consultants in Geotechnical Engineering
Geology and
Environmental Earth Sciences Proj, No. T-5480T&te DEC 2003 Figure 4
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02/23,12004 16:52 FAX 425 821 4334 ASSOCIA'I'FS
Inc.
TERRA ASSOCIATESo
Geote(liflic"li Consultants
9V34
�,%,i 1,.2ws Road, 5�.Jjte 10,, Kirkland, WAs
(4i', 7,� C -4-134
Mom '42S/ tj2l -7/7 77 * Fax , I - —
FOOT114G EXCAVATION EXAMINATION REPORT
DKiEFOCOTINGSEXAMINED PROJEcTmo.
PROJECTNAIAE: PROJEC-rk-OCX'1014:
RF-PRESENTATIVE: Roy
CONTRACT09:
MSCRIPTION OF Fjc.Tj%4Gs COVERED BY 7H*S REPORT'
r9m
-jit,; ol this pxprj,rat;cn am only valIQ icr a
our reptesentativ8 I-r-1 OxarninGd 0,)Iy �V, Icct,.-Ig exuam�ations Itated above. Trio ros Li AT/ loosened s,,-:.IS ObServee.
)qraca condl,.Ions accu-5. \qo should be profni)4' -*Wie
period of 48 hours. 14 arv/ change in the sut 6 prior to om-:,rote placement.
ct* t vity or rpinfall &CLId be iemove
nT,0L.nc3aI:or*. amas die tOc strL vac
7A (1-C!" TO:
RF-C-EIVED
TEnpi�'�S�OC::ATFS RE,-r-ESENTArIVE FELI 2 7 2004
DEVELOPMEN1 SERVICES C'FPN'
CITY OF EN30NDS
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Inc. 1 8W3
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 9W2O - (425) 771-0220 - FAX (425) 771-0221
Website: wwdedmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
May 20, 2004
Scott Catton
736 Dayton St.
Edmonds, WA 98020
Re: Building Permit: 2004-0109
Site Address: 8729 Main St.
Expiration Date: February 6, 2005
GARY HAAKENSON
MAYOR
The purpose of this letter is to inform you that the last remaining inspection on your
project is a final inspection(s). The final inspection(s) determines that there are no
outstanding life -safety issues and approval allows the City to close your permit file.
The City considers the final inspection to be one of the most important inspections
conducted on a project. In order to grant final approval the following must be complete:
smoke detectors, house numbers, guardrails, handrails, self -close doors between garage
and residence, egress from sleeping rooms, safety glazing, weather-stripping, any
Engineering department requirements etc. Of course not all of these things may
specifically apply to your project but it does give you an idea about the kinds of things
that must be complete as well as some items that do not need to be installed such as:
paint, carpet, moldings, wallpaper, etc. Please be advised permits expire one year from
the date of issuance. If you will need more time to complete the work, permits can be
renewed prior to expiration for one half fees. If the permit expires without a final
approval granted by the Building Inspector, full fees are required in order to renew the
permit. This can be very costly to you and we strongly encourage you to check your
permit expiration date and call for the required final inspection(s). Note: If more than
one department is required to final your project, this is noted on your Job Card.
Please feel free to contact me at 425-771-0220 if you have any questions.
incerely,
y Readwin
e rmlt Coo
rmit Coor=dinator
L\TeaT\DST's\Master Letters\SRwaamLtrSFR
Incorporated August 11, 1890
Sister Citv - Hekinan. Jaoan
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SCADE TESTING LABORATORY, INC.
TESTING & INSPECTION / ENGINEERS
12919 N.E. 126TH PLACE
KIRKLAND. WASHINGTON 98034 (425) 823-9800
0=2�joj EVERETT (425) 259-0817
FIELD REPORT
TO:
PREVIOUS No. 119869
- I
DATF_
=�
ERT. NO. 4
QrI30
PROJEr
LOCATION
9-7 2-4? ffiaur,� 4_=A
BLDG. PERMIT NO.
'q ryuj- CIO
A X 0 J ILLL�,I-f - 6A It-, U-&4-4—
ENGIN
RECEI gL
V :0 ARCHI
ATTN: MAY 2 1 2004
CONTI
(2)
INSPECTION PERFORMED
RESTEEL/CONCRETE — RESTEEL ONLY
R EUMASONRY — STR.ST[WELDING
OTHER — STR.STIBOLTING
(4) - I— D
LOCATION (AREAS)
A, A 0 L.0 r\'
TEMP. AT AM
AT PM
V., e. q
(3)
ITEMS INSPECTED
— FOUNDATIONS
FOOTINGS
— SLAB —
AUGER CAST PILES
— COLUMNS
DRILLED PIERS
— WALLS
— BEAMS
(5)
CONCRETE/MASONRY MIX NO. DESIGN STRENGTH (f'c)
SUPPLIER TOTAL CU. YD. PLACED
SLUMP (INCHES) SPECIMENS CAST
AIR CO SEE CYLINDER REPORT NO.
YES _No ITEMS INSPECTED WERE IN CONFORMANCE WITH BLDG. DEPT. APPROVED PLANS
N\44% enk ct C LA -,.-
REMARKS:
D
TEST RESULTS APPLY ONLY TO THE ITEMS
HEREIN TESTED. THIS REPORT SHALL NOT INSPECTOR(S). NAME(S) PRINTED
BE REPRODUCED EXCEPT IN FULL, WITH-
OUT THE WRITTEN APPROVAL OF CASCADE
TESTING LABORATORY. INC. INSPECTOR SIGNATURE
REVISED 8/00 SIGNED BY
COPIES TO:-=_t�
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RECEIVED
SEP 12 2004
DEVELOFIAENT SERVICES CTR.
CITY OF EDMONDS
11644N.E,80thSt, Kirkland, WA 98033 (425)828-4117 FAX(425)822-1918
8101 S.W, Nyberg Rd, Tualatin, OR 97062 (503)692-8127 FAX(503)691-0517
Height Calculation Worksheet
Address:
Date:
L ector(s):
Isp
1. Datum Point: zrx��-\
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2. Datum Point Elevation:
0
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3. Average Grade: 0S.
+ 5 .)d-b. CAO
.4. Maximum Elevation Allowed: averagdgiade)`2
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5. Reference Point Elevation Shot to House:
0
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6 (datum elevation) + b (grade to transit level Une *shot to house)
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6. Measurements from line shot onto house to roof ridge:
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7. Actual Elevation: �1'4 (reference point elevation . (measurements
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Conclusion:
(actual) is greate --Ws th*n (allowed); therefore the house is/
is not over the height requir=ent-ptr�ECDC 16.20.30 requirements
J�JAH 2e '04 04:33PM PIPER JAFFRAY INC
CITY OF EDMONDS
SPECIAL INSPECTION AND TESTING AGREEMENT
The pmject at ur)der building
—T— reqi lnsp�ction and/or testing per UBC Chapter 17
permit number =E-111-71 uires special i
and WAC Amcndincnts 1702. The comEpLete list of special inspeebons is anaciiid to tb�is document.
BEFORE A IFIERMT CAN BE ISSUED: The owner and contracto� and special inspector shaU
completo th�.s aqeernent and the attached structural test(s) and inspections schedule including the
requirW acl=owledgments.
AP . PROVAL OF SpEcLAL ][NsPECTORS: Each special inspector shall be approved by the
Building Official nor to pexforminsapy.duties or tions. Each special inspector shall submit
1? . I' Special inspectors shall display
statmwt a*,. cations to the uilding Official r review.
identification W Pen p3efforrami special inspections on site. Special irispection and testing shall meet
1_
the minimtx,71, requirements of 6BC Chapter 17 and the followiiag:
A. Duties K Ic-smial Insp"J."
1. Obse.:,-ve Work
The special inspecto, shaU observe the site work for conformance with the approved
(staquyed) plans and sp�cificatiO]15 and applicable workmanship provimons of the 'UBC-
Architect or Eqineer reviewed shOP drawings may be used only as an aid to ftispection.
�pec;ial inspections are to be performed on a continuous i basis —meaning that the special
�nspector is on site at aU times observing the work requihng s ecial inspection. Periodic
lasp--ctions, if any, must have prior approval by the Ciry,bas on a separate written plan
revi,:iwed and approved by the B Official and the engmeer or architect of:record.
2. Izepurt Non -conforming I!ems
The special inspector slall 'bring noncontomung items to the ir=ediate attention Of the
contTactor and note all such items in the daily field rqport. Any item not resolved in a timely
mai r mr shall be immediate cause of th.e special inspector to nott fy the Building Official of the
plau deviation error, change or omismon. it sliall also be the duty of the special inspector to
proij:-,ptly noti?y the engineer or architect-
3. Complete Daily ReporU
Each special mspector shall c!ornplete and sign both the special inspection record and the daily
rcporl form for each day's insp=tion. These records shall ren�ain at the jobsite with the
conT.r3ctor for review by the City Building Inspector.
4. Furnish Weekly Reports
The S rgaicy shall farnish the City with weekly reports Of tests
pecial inspector or inspection ag
and ir�ecfions. The jcr_t engimeer.or architect, and others as designated shall also be
copied on repo:rts, WeelTy reports must include the following:
Des -ription of daily im-ipections and tests made with applicable locations
r
List of all nonconforming items
it Report on status of noncoaforming items (rcsolvc4 or unresolved)
Iteft-tized changes authorized by the Arc�hitect, Engineer and City if not included in
nonconformance items
S, Fum.jjh Final Construction Repoirt
rhe ")Ccial inspector or inspeCtIonagency shall submit a final signed report to the City stating
that --;I itcms requiring e4ial inspection and testin were fuffilled and reported. And, to the
best'.-,f his/her knowlelge the pro)-ect is in coNormance with the approved. plans and
and the applicable worlananship provisions of the
a-pecl. I sations, approved change orders
TIBC Items not in conformance or unresolved items or any discrepancies m impection
'cove!�,:Lge, (i.e., missed inspections, pe-liodic inspection when continuous inspections were
reqm-,A, etc.) shall be specificAly itmnized in tl�s report. /
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�04
JFJAN 28 - '04 04;-f3PM PIPER JAFFRAY INC /10
ReSIDqnsibilities
I. Notify the Special ]Inspector
It is the duty of the contractor to notif� the special inspector when work is ready for special
jiispection. Note, the items listed on the atwhed schedule md as noted on the approved
plans and specifications are required to have special inspections. Adequate notice shall be
provided by the contractor so that the special inspector has time to become familiar with the
project.
2. Provide Access to Approved Plans
The contractor is responsible for providing the special inspector access to approved plans at
thejobsite.
3. Ret;ain Special Inspection Records
Tile contractor is responsible to retain 'at the jobsite all special Inspection records submitted
by the special inspector. These records are to be provide6to the Ciiy building inspector upon
request-
C, Cit, 9; E dMoults_Bnading Delp uument onsihilifies
1 - A0101rOvc special iDWOOrs Or iUWCtj0n agencles
%c- building department sball approve all special inspectors and special inspection
requirements.
2. Monitor special inspection and approve weekly reports ectors, shall be
Work requiring special i ti n and the performance of special insp
�-6%tained prior to
.Moliatored by the City BuiiTdingolnspector. His/her approval must b
placement of concrete or other similar activities in addition to that of the special inspector.
3. Issue CertUicate of OccUP2ncY mpancy after all weeldy special inspeWon
The Building Official may issue a Certificate of 00
reports including the final report have been, submitted and accepted.
I
owner Rupan-gNiffies
'ne project owner or the engineer or architect of record acting as the owner's agent shall fimd
special inspection semces.
E. Engineer 0 ect ol RgcQrd Rftlionsibilitta
The enginecr or a hilect of record shall include special inspection requirements on the plans and
specifications.
AC]KNOWLEDGEMENTS
I liave rea� and agree to comply with the terms and conditions ofthis agreement.
ate, r-
Owner---':
Date
Special Insp6ctor
Ge'neral Contractor ---.Date I lav I C��
City Building Offici
; bp
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ol/26/
j7CIRRA ASSOCIATES
'JAFFRAY
W1 1111 /
P .10/19
P. 3/4- L�4
B, - Cori tax-ReanGaMin
1- Notify �hv Spm:W Wpector
Ic is the duty of the con=ctor to votfy the spccW inspector when work is ready for special
m . spect= N.ote, the ite= listod cm ft armched schedWe =d as noted an thr, approved
plam md speaffic-ations art, required to have special in4wduns. -Mequate notice sball be
pravided by thz conft-4ztar so dia ffie special idspector bas timc to become &milim with tht
proi ect. I
2. Pro�ideAocaGstuAPproved.Plabs;
The- con=mr is�re4mhsiblc for providing the 4mcial inspector accew to appmved plans at
3. Retain SpecW Inq9tfiam Records
r is iosp=ak io retain at the all 'al r& 'ttnd
710 ccutuft apm 1nspccWm rcoo submit—
by-�ht speeW inspeaftT. Ilese records to provide6w the City building in�or upon
-C.-
1 'Apiprove spedal impeciers or laqwfim agendes
rf&� - traildirtZ dcpzrtmfmt slmll aMrove &U qxcial iWactars and special inspccucu,
I 'Moy.ftor spedid ln�pection and 2ppro" wmkbr reporU
Work on =d' 1b 0 of SPCCW iaspecA= da be
e TV-"fouer4aa=npcpDiroYaJ must be )jAajnrA prior to
inomE! 7bidn'ighe&P8itya1B Inspeepr.
4
pla�czncnt o ctmcmte or other shilar actvifics in addi6�n to tha of the spaial inspector.
3- Issar. Cerd9catc of Occupancy
The Building Official 4
_;nay ism a Cxrd&-afc of Occupancy after all Wa4dy rpeoial hzs�oll
rqports tacluding tbg ft,19 rq)oft bavc bom xubmifted Rnd aoMted-
The p�ajcct owrw ar fbe enginew or architca of rteord acting as the owner's agent ahall fimd
special inspection Gem=.
U, a z M. (07 TO 1 11 T. q, -671 M.- 17 1 i f ;
ACKNOVUXDGMENTS
I h a ve.ry ad and agree to comply -Kith. the I erw an d co n dido = ofMis agr" M 014
Special lnspec.i-
CA
Cx==;a C*wractor
City BWldirg O�ffi
/ / 2- FI/O
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2jAN 2e 104 04:34PM PIPER JA::*FRA'Y' IMCNG
r.Lrr-m j;�-rnr,,
425-823-2203 . .-I P. 9/10 - 2
3. NOWTOm speda Inspector
of the conw
it is the duty notitr dm q3=11 inqxctar whm work is juuW fbar special
on. 140tc, the iu=s listed on the UWcj=A sc�atule Aa as noted on the approved
invecli all be
pl= and specificafi=s are required to b;Lvc specil) h1S1=tiOns- -Adequm notice sh,
providod by the conawtor so that The specW iaspecuw has time to become familiar with the
projccL
2. Provide Acmv to AIPPrOvCd PIMIMS
Tb,a conmgw is rcqxwhiblc far roviding tho special inspector amm to VPTuvcd plans at
thcjobcite.
3. -Re"iR Spe4aj Inspeakm RKOrds b m's
ne conmetmr is respowiNe ic retatm At the MtO aU pection rec"& svb=itttd
by the special hmpoclOr. TbW recards are toj� pmvidasd9teo"the City building ins� UPDn
C- city
I. ApProve Wedw imspedors or bxpwtias acendes d spwzial inspactioxi
7he building dqmrftmcW Ghall awmve all Speew inqloctolrs an
reqau=Pt=t&
2. r4oQjUW speaW jUjpv . eCign snd *ppro" wnkly reparts shall be
umng zpc�iai tion and the 1O=acsd
Wqrk rcq prior to
;namtcmA b tbit Cit)r =usz b
y the Special inSpedDr.
plw=cnt of concrete or Other Ui6211a ktivities in addition to that of
3-' LL&ur CertWacate of Oc"PASeY a Catfic&w of O=paucy after all We&1V %I&Cial inqx=fiGn
Mhe Building OIScW t"y lqsuz
repoms Mwjxj� ft fasl report bave begn albaniTtod and 300epted.
D-
Tic P�Ojact owner or the engmeer or zchj�w of rccord acting a the owYmes agent shaD fimd
Spernal. inspection zeyviccs.
CWS ou the plans and
The rmg6= Or arewlect O:f r�� xW in4ude specW inspcefion rcQu=m
spcciraczxions.
AcXN()WLMGEMENTS
I haw read and agy= (o comPtY wiMAD INNU and condidow of thil o'gremmen't
ow=---� - P
spe�:ial InspCetor
<:k=Cj-4
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
PLEASE SIGN
ENGINEERING DIVISION DATE__8/,,e
111 PI EA E SIGN
PLANNING DIVISION DATE
PLEASE SIGN
PROJECT 1,4
SITE ADDRESS 7 2--49 AIA t tlL S 7-
PERMIT # 2-0!2 �- —O)Z(I)&! ADB# DATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED
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
PERFORMANCE BONDS and the granting of:
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
o Copy of CONDITIONS given to owner/contractor by inspector
I .
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
c3 Copy of CORRECTION NOTICE given to owner/contractor by inspector
1 .
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date
ocaprv1.doc.1:temp:b1dg:fbnns 10/01
Sign.
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I 1� n
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
ETBACKS .....................
V> FOUNDATION:
Footing ......................
Wall .......................... vv-)
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -In ....................
Commercial Final ......
HEATING:
Gas Test .................... n S
Gas Piping .................
Equipment .................
Commercial Final .......
EXTERIOR SHEATHING
NAILING .......................... n-
FRAMING ........................ M Tz, <�
FIRST FLOOR FRAMING ... 7
7-
INSULATION ...................
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
SUIe Sewer fe'_
Amout Paid --ONO I
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AmountPaid—,..
Date PurchnsCC
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A m o u n t
Date L
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