20040137.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
D���ViPA LU�
MAILING ADDRESS
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CITY ZIP TELEPHONE
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NAME
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ADDRESS
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CITY
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NAME . 1 (9 P,
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ZIP ITELEPHONE
761015 12P�o 514
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ZIP ftELEPHONE I
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STAfE-LICENSE NUMBER
EXPIRATIC,�LDPITE
CHECKED BY
C� L
PROPERTY TAX ACCOUNT PARCEL NO.
0c`ic5907c"c>0— o4o
NEW
RESIDENTIAL
PLUMBING / MECH
ADDITION
COMMERCIAL
COMPLIANCE OR
CHANGE OF USE
REMODEL
MULTIFAMILY
El SIGN
REPAIR
FENCE
11 ( x FT)
GRADING
CYDS
DEMOLISH
TANK
OTHER
EiGARAGE
Ei RETAINING WALL
FIRE SPRINKLER
ALARM
CARPORT
ROCKERY
FIRE
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
cor-Fr-le 11::.WyLAF6
cogXJW-� 5TOF-E
NUMBER
NUMBER OF
CRITICAL
OF
I I
DWELLING A
AREAS , NA�
STORIES
UNITS
NUMBER
DESCRIBE WORK TO BE DONE
remoutA__ w5pr\r(r CoFrt-E- a0f or 6� �15r-
rIM6r EXT 9;4APitW _5Y01_
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HEAT SOURCE GLAZING % LOT SLOPE %
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PLAN CHECK NOm VESTED DATE
I
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
J SEPARATE PERMISSION.
PERMIT APPLICATION: 180DAYS
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
cn *APPLICAN1, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
I IN INTEREST AGREES TO INDEMNIFY. DEFEND AND HOLD 14ARMLESS THE CITY OF
2 EDMONDS, '�ASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
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ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIREC11-Y
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF 'THIS PERMIT SHALL NOT 13F
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CHYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION� THAT THE INFORMATION
GIVEN IS CORRECT. AND THAI 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 COMPENSATIO �ANCE AND RCW 18.27.
SIGNATPPE (OWNER NT)-' DATE SIGNED
f )-- 0
PERMIT EXPIRES�C�_
USE PERMIT
ZONE
NUMBER
JOB SUITFVAPTAt
ADORES
V
PLAT NAMEISUBDIVISION NO. LOT/40� LID NO.
LID FEE $
I ESCP Apploved
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Rnitusted 13
Street Use Permit Roq'd E3
EXISTING - PROPOSED inspection Required 13
Sidewalk Required C3
REQUIRED DEDICATION- FT Undefgiound
Wiring torItiored CI
METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
I I 1 (71 YES 1:1 NO A
REMARKS
OWNERICON TRACI 014 RESPONSIBLE FOR EROSION CONTFIOL/DRAINAGE
ENGINEERING REVIEWED BY
DATE
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POSTED
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SEPA REVIEW SIGN AREA ' HEIGHT
COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED , PROPOSED
EXP
LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT L/PSIDE REAR
PARKING
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CHECKED BY
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OF
E OCCUPANT
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AREA iCCUPANT
SPECIAL INSPECTION r -Tr-,Af LOAD
REQUIRED El Y
ES
REMARKS
1PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D
A-1 _. . -7 1. J A I i / I I I . I A , i % �—%
VALUATION
$ f
Description
Plan Check
Building Permit
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Fire Inspection
Landscape Insp.
Recording Fee
CALL
FOR INSPECTION
(425)
771-0220
FEE Description
j�qll� State Surcharge
;-)q City Surcharge
FEE
— I 5�� I t<�5 -
Plan Chk. Deposit
Receipt #
Total Amt. Due
ZL�? -
Receipt # 7
APPLICATION APPROVAL
1 hisapplication is not a permit until signed by the
Building Official or hisihor Deptityi and Fees are paid, and
iecLipt is acknowledged in space provided.
:FjCIALS/.SIt;NAF F DATE
ATTEWION j tA I I jjj; I I �
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL L
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 r
04,02 PRESS HARD -YOU ARE MAKING 5 COPIES
BY
DATE
A,
ORIGINAL - FILE
YELLOW /INSPECTOR
PINK - OWNER
GOLD - ASSESSOR
GREEN
- ACCOUNTING
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DEPARTMENT OF BUILDINGS
PER UNIFORM BUILDING CODE SECTION 109
At:— 21900 Highway 99, Edmonds WA
occupancy established by this certificate: Dwell
B Type
uilding Permit#:
Units: *N/A**
Construction: VN
37
No. Stories: 1
nkle I Basement: N/A
Maximum occupant Load - **49** (Per U.B.C. 1002)
Room capacity signs, when required, must remain posted at all times.
Owner of Building: Terravida Co 'ee LLC Address: PO Box CS-9711. Bellingham, WA 98226
THE Terravida Coffee HAS BEEN INSPECTED AND APPROVED AS COMPLYING WITH THE REQUIREMENTS OF THE 1997 _Ecrition of
the UNIFORM BUILDING CODE AS AL)UP I ED BY THE CITY FOR THE GROUP AND DIVISION OF OCCUPANCY AND THE USE FOR WHICH THE
PROPOSED OCCUPANCY IS CLASSIFIED.
issued this 29th - day of________AprjiI 2004 _
CHIEF BUILDING OFFICIAL
BY: / �X64W44�-
s a building permit and a new
1 his certificate shall be posted in a conspicuous public area and shall not be removed. mutilated or obscured and shall be maintained in legible condition at all times. Any change of occupancy or uso require
Certificate of occupancy issued by the City of Edmonds Building Official.
4A 10
"A'
-------- --------
1994 Washington. State Nonresidential Energy Code Compliance Forrn
'SMi
S ma* ry,
VG,
1994 Waghhgton state Nonrasid"al Energy Coda Cornplance Fonns S000nd EdHW - Jurm 1995
Project Wo
Project Address V F0 6-
Date
100 HNq 11
For Building Department Use
iAA ^ %A Av
1,2 - Ll 0 Q 2. Ca
Applicant Name:Terrl
Vida Ooffee . LLC.,
Applicant Address:- 5 - -7 . I
Applicant Phone: lb(
,00. -757. .&q 17 '. 206 541-m% A�ftbi)4
Project Description —TE] New Building Q Addition Alteration
ICompliance Option El Prescriptive S Ughting Power Aillowance U Systems Arvaly�s
I (See Qualification Checklist (over). Indicate Prescriptive & LPA spaces clearly on plans.)
Alteration Exceptions El No changes are being made to the lighting
(&e& appropfiate box) I El Less than 60*/6 of the fixtures are new, and Installed lighting wattage Is not being Increased
X4.qYirniitn Allowed Liehtiniz Wattage (Interior)
Location
(floor/room no.)
Occupancy Description
Allowed
Watts per fe
Area In fe
Allowed x Am
A100.A101
Via come- evwst& 4 .5eat�m
1.*S
1000
C11
;C. ve- OPW stvic-+T�rz C!O 4�
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15 *C L IS '26
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1-17
Frc m Table 15-1 (over) - document all exceptions taken from footnotes * Total Allowed Wafts_
17740
Prn,nncpd Licrhtina Wattaize (Interior) (May not exceed Total Allowed Watts for Interior)
Location
(floor/room no.)
Fixture Description
Number of
Fixtures
Watts/
Fixture
Watts
Proposed
e
Total Proposed Watts may not exceed Total Allowed Watts for Interior
Total Proposed Waftl
1 701
&4.-,;T.n.,-vrn Allowed Liahtine Wattaize (Exterior)
Location
Description
Allowed Watts
per ft2 or per H
Area In f?
(or ff for perimeter)
Allowed Watts
x fe (or x ft)
Covered Parking
0.2 Wfle
Open Parking
NO (-AAHCqF -M L2151
0.2 Me
Outdoor Amu
CON D M6 W
0.2 Me
Bldg. (by acade)
0.25 WIte
Bldg. (by pedm)
7.5 W/If
Note: for buildng exterior, choose either the facade area or the perimeter method. but not both) Total Albwed Wafts
— NA
'Pv^v%r%a,aA T.;crhtina Wattacre (Exterior) (May not exceed Total Allowed Watts for Exterior)
Location
Fixture Description
Number of
Fixtures
Watts/
Fixture
Watts
Proposed
—M—KITY7
N* (s- E
DAW Mmu
t< 5 C
E E)
Total Proposed Watts may not exceed Total Allowed Watts for Erdor 2�%l Proposed Wattsl
— KA
t-w'F.RMIT COUNTER
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1994 Wanhinatan State Nonresidental Enerav Code Comptlance Form
1904 Washington Staft NonroWental Energy Code Compliance Forna
Prescriptive Spaces Occupancy Q warehousw, storage aran or aircraft storage harvers Li Odw
Qualification Checklist Lighting nxwres: OCheck here it at least 95% of fixtures In the space meet al four atteft
Note: H occupancy type Is '00we and fixh"
wwww Is d*dW, ft number of fixtures in 1. Fbctures are fluorescent non,4�, with only one or two lamps, and
ft space Is rod Urnked by Code. CWdy 2. Lamps are T-5, T-6, T-8 or PL, and 3. Lamps are 5-50 Watts� and
Indicate #*&a spaces on plam If not
Walified, do LPA Calculatione. 4. Ballasts am electonIc ballasts
Table 15-1 Unit Lighting Power Allowance (LPA) for Interior Lighting
Use'
L.PAR
(W/ft)
use,
LPA!
Palntlng,;;; ry, rnachlne shops ---
2.3
Police and fire stabore
12
Barber shops, beauty shops
2
Aft (abiums)
- - �
1
Hotel NVnMVConfeMnoEVe)h1bMM halp.4
2
Assembty spaces". auditoriums, amy%aslas, fteters
1
LabDndodes
2
Process plants
1
Aircraft repaJr hyxiars
I iXL
RestauranWbars'
I
Cafeledas, Iasi food establls;hments6
Retall A'O
Factories, workshops, handling areas
ROWI B'O, RatEkll bankft
1.5
statiom, auto repair stme
1.5
Locker andlor shower WIttles
113�
Institutions
1.5
Warehouses", storage areas
0.5
Libraries'
1.5
Akcraft storage hangers
0.4
Numing ham
1.5
Paldng garages
S" ROOM ISM
Wholesale stores (pallet rack sheMng)
1.5
Mail conoomes
1.4
Pians Submilted for Common Areas OnIY7
Sch4ols buildings, school classrooms, day care centors
1.35
CcaTnon area, oonidors, lobbies (0)COpt mail concougJa
0.8
Laurx1fles
1.3
To(Iet facilities and washrooms
U.0
office buildings, officeladmInIsftratIve aress In facilities of
ottw use types (including but not limited to s&K)ols,
,hospitals, Instituft-is, museums, banks, chUr&teS)6'7'11
1.2
I -
I ---
Footnotes for Table 15-1
1. In cases in which a use isnot mentioned specifically, the Unit PavwrAUowance shall be determined by the building official. This
determination shall be based upon the most comparable use specified in the table. See Section 1512 fbr w=pt etreas
2. Ile watts per square foot may be increased, by two percent per foot of ceiling height above twenty feet, unless specifically directed
otherwise by subsequent fbotriates.
3. Watts per square foot of room may be increased by two percent per fbot of ceiling beight.above twelve feet.
4. For all other spaces, such as seating and common areas, use the Unit Ldghr PowerAllowance for assembly.
5. Watts per square foot of room may be increased by two percent per foot of ceiling height above nine fed.
6. Includes pump area under canopy.
7. In cases in which a lighting plan is submitted for only a portion of a floor, a Linit Ughting Power Allowance of 1.35 may be used for
usable office floor area and 0.80 watts per square foot shall be used for the common areas, which may include elevator space, lobby arce
and rest rooms. Common areas, as hcrcin defined do not include mall concourses.
8. For the fire engine room, the Unit Ughting Power Allowance is 1.0 watts per square foot.
Ii anor for the owrt area is 2.6 watts per
9. For indoor sport tournament courts with adjacent spectator seating, the Unit ghtingPowerAllow
square foot.
10. For both Retail A and Retail B. light for firce-staoding display, building showcase illumination and display window illumination installed
within two feet of the window are exempt.
Retail A allows a Unit lighting Power Allowance of 1.0 watts per square fooL Ceiling mounted adjustable tungsten halogen and FM
merchandise display Muminaries are exempt.
RzAafl B allows a Unit Ugbting Power Allowance of 1.5 watts per square foot, incJuding all ceiling mounted merchandise display
luminarim
11. Provided that a floor plan, indicating rack location and height, is submitted, the square footage for a warehouse may be defined. for
computing the interior Unit Ughting Power Allowance, as the floor area not covered by racks plus the vertical face area (access side only)
of the racks. The height allowance defined in footnote 2 applies only to the floor area not covered by racks.
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LIGHT FIXTURE LEGEND
MARK
OYMIBOL
FIXTURE TYPE
QUANT.
WATTrrIXT.
WATTS
LAI
--2s7—
LOW VOLTAGE ADJ. TRACK �EAD, TRACK MNTD-
1
35
245
LA2
LOW VOLTAGE ADJ. 4" DIA. DOLINLIC-A-IT
6
-45
210
LAB
LOW VOLTAGE ADJ. 111/ 84QUARS TRIM
35
210
LA4
LOW VOLTAGE ADJ1. TRACK WFJO, CLa MNTD-
3
20
60
LF1
e
Ir-LY13ACK' TRACK FIXTURE
4
r2o
200
Lr-2
r ------ =1
LINEAR WALL UIASI-ER
OMIT
2'X 4'LAY-N
2
62
124
LF4
0
6" D [A ROJ40 FLUORL DOUNLIGHT
10
21
210
FLUORESCENT STRJF
3
LFfo
0
12 CIRinLAR FLUOR STRIP- MOUNT IN FIXTURE 5ELO-U
1
40
40
LF1
P040ANT CYLINDER 001INLIGHT
3
32
C.*
ARCHITECTURAL PENDANT - 15 W
1
15
105
so
INC-ANDESCENT WALL SCONCE
2
15
30
TOTAL WATTAGE
1161 WAT TO
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DAT
SIGN
ENGINEERING DIVISION DATE
PLEASE SIGN
PLANNING DIVISION DATE
PLWE SIGN
PROJECT
QA L 0("? 4-K
SITE ADDRESS 0 L�'�4
L
PERMIT ADB# DATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED 7-[
A field inspection was conducted to determine 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 :
)0(- GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
0 Copy of CONDITIONS given to owner/contractor by inspector
1 .
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0 Copy of CORRECTION NOTICE given to owner/contractor by inpector
I .
Pi
0,
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:temp:b1dg:fonns:ocaprv1 3/25/04
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FINAL PROJECT APPROVAL FORM
TO:
DA
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
PLEASE SIGN
ENGINEERING DIVISION DATE
PLEASE SIGN
A-), o PLANNING DIVISION DATE24/__';� 0
PLEASE SIGN
PROJECT
SITE ADDRESS ;Dn 0� oo 1-1—c"OVI
PERMITJJ �XV-H)e�5_1 ADB# DATE INSPECTED
T
DESCRIPTION OF WORK TO BE INSPECTED
A field inspection was conducted to determine 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
0 Copy of CONDITIONS given to owner/contractor by inspector
1 .
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0 Copy of CORRECTION NOTICE given to owner/contractor by inpector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:temp:b1dg:fonns:ocaprv1 3/25/04
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall ..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -In ................... L04
Commercial Final ......
HEATING:
Gas Test ....................
Gas Piping .................
Equipment .................
Commercial Final .......
EXTERIOR SHEATHING
NAILING ..........................
�7
FRAMING ........................
FIRST FLOOR FRAMING...
INSULATION ...................
�2� -
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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