20040314.pdf0 1 DATE RECE
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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PROPERTY TAX ACCOUNT PARCEL NO.
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GRADING CYDS
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NUMBER NUMBER OF
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PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REQ'D
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VESTED DATE
THIS PERMIT AUTHORIZES INAILY THE WORK NOTED. THIS PERMIT COVERS WORK TO
I: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
w PERMIT APPLICATION: 180DAYS
CL PERMIT LIMIT., I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
W OAPPLICANT, ON BEHALF OF HIS OF] HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
13 IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
M EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIREC'IIY
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 I HE CITY'S ABILITY 10 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 DU& 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 10
WORKMEN'S COMPENSATION INSURANCE AND RCW 18,27.
SIGNATU E (OWNLH ��AULPII'l I
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VALUATION
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Description
Plan Check
Building Permit
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Fire Inspection
Landscapelnsp.
Recording Fee
FEE
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CALL
FOR INSPECTION
(425)
771-0220
ATTENTION k-.z I E)ff 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
, 5_0 ___
Description FEE
State Surcharge Is.__
City Surcharge 1-1 . 6 61
Base Fee
Plan Chk. Deposit
Receipt #
Total Amt. Due
Receipt #
APPLICATION APPROVAL
This application is not a permit until signed by the
Building Official or hisither Deputy: and Foes are paid, and
receipt is acknowledged in space provided.
ZPCIIGrNAh DAT E
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7LEASED BY DA`rE
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
if -FILE YELLOW - INSPECTQ
OWNER GOLD ASSESSOR
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DEPARTMENT OF BUILDINGS
PER UNIFORM BUILDING CODE SECTION 109
22511 Highway 99 # 102
Building Permit # 2004-0314
Occupancy established by this certificate:
B
Dwelling Units: **N/A***
No. Stores: 1
T pe of Construction: VN Spri
kle
I Basement: No
Maximum Occupant Load ***32*** — (Per UBC 1002)
Room capacity signs, when required, must remain posted at all times.
Owner of Building Welcome Market Inc. Address: 6281 Regio Ave, Buena Park, CA 90620
The BCD Tofu House has been Inspected and approved as complying with the requirements of the 1997 Edition
of the Uniform Building Code as adopted by the City for the group and division of occupancy and the use for which the proposed
occupancy is classified.
Issued this 4 th day of August, 2004
CHIEF BUILDING OFFICIAL
BY:
This certificate shall be posted in a conspicuous public area and shall not be removed. mutilated or obscured and rhallLe, ntined in legible condition at all times. Any change ofoccupancy or userequires a building permit and anew
Certificate of Occupancy issued by the City of Edmonds Building Official.
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FINAL PROJECT APPROVAL FORM
E C. E IV E ID `�' ( I
�JUL 2 82004 TO: '161 ca�
0EVELOPMENT 3ERv1r.;Es cm. DATE: 7 /42
CITY OF
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
ENGINEERING DIVISION DATE
PLEASESIGN
PLANNING DIVISION DATE
PLEASE SIGN
PROJECT
SITE ADDRESS DJ
PERMIT #?P�!Jn Bft_
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DATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED Y
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
PERF ORMANCE BONDS and the granting of :
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_.z'-J�I-w GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
0 Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0 Copy of CORRECTION NOTICE given to owner/contractor by inpector
1 .
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:temp:b1dg:fbrms: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 .................
Commercial Final ......
HEATING:
Gas Test ....................
Gas Piping .................
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING...
INSULATION ...................
Floor Insulation .........
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Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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