20040441.pdfI
DATE RECEIVED 11116
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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CITY ZIP TELEPHONE
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STATE LICENSE NUMBER
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EXPIRATION DATE
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NEW RESIDENTIAL
PLL
LUMBING / MECH
ADDITION COMMERCIAL
COMPLIANCE OR
CHANGE OF USE
REMODEL MULTIFAMILY
SIGN
GRADING
REPAIR CYDS
FENCE
( � x FT)
El DEMOLISH TANK
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OTHER
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GARAGE RETAINING WALL
CARPORT ROCKERY
FIRE SPRINKLER
FIRE ALARM
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(TYPE OF USE. BU ESS P�JTIVITY) EXPLAIN:
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NUMBER
OF
STORIES
N UM ER OF
DWEBL NG
UNITS &/4J
IGRITICAL
AREAS
NUMBER
DESCRI13E WOhK TO BE DONE
N 'zS 5— 60 f-% (%-A
PJEF�
HEAT SOURCE I GLAZING % — I LOT SLOPE %
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USE
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ADDRESS :2!�� 2S
PLAT NAMEISUBDIVISION NO
PERMIT EXPIRES
PERMIT
NUMBER (*v/1h
SUITE/APT#
01 NO, LID NO.
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved
FjW Permit Requited
Street use Permit Floq'd
EXISTING - PROPOSED
inspection Roquabd
Sidewalk Required
REQUIRED DEDICATION- FT
underground
Witing required
METER SIZE LINE SIZE NO. OF FIXTURES
PRV REQUIRED
I
YES 11 NO 13
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
ENGINEERING REVIEWED BY DATE
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FIRE REVIEWED BY DATE W
VARIANCE OR CU SHORELINE OR AD)TB#INSPECTION BOND
REO'D POSTED
D oy
I YES ONO S
SEPA REVIEW SIGN AREA HEIGHT
COMPLETE EXEMPT ALLOWED I PROPOSED ALLOWED , PROPOSED
EXP I
LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR
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PARKING LOT AREA PLANNING REVIEWED BY DATE 5
REO'D I PROVIDED I 1 91.
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CHECKEDBY ITYprffN 0
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Ct -7 OCCUPANT
)PE GROUP
SPECIAL INSPECTION
AREA
OCCUPANT
REQUIREDE] YES
LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REO'D
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VALUATION
Description
FEE
Description
State Surcharge
City Surcharge
Base Fee
FEE
Plan Chk. Deposit
Receipt #
Total Amt. Due
-A Receipt #
APPLICATION APPROVAL
This application is not a permit until signed by the
Building Official or his/her Deputy: and Fees are paid, and
receipt is acknowledged in space Provided.
OF IA
.ELC ATE
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ED Bf D TE
A17ENT1014 E)ff 1333
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
09!03 PRESS HARD -YOU ARE MAKING 4 COPIES
PLAN CHECK NO: VESTED DATE
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
.j
SEPARATE PERMISSION.
PERMIT APPLICATION: 180 DAYS
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PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
0 U) 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY or
M EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECILY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY C" ORDINANCE
0
M NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PrIOVISION.'
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
WORK4.EUS-.QoM PENSAT�� RANCE ANQ_RCW 10.27,
I DATE SIGNED
; 4 .49 _doD
pllii I I Fj F01A ME 60A.15.1020M
Plan Check
Building Permit
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Fire Inspection
Landscapelnsp.
Recording Fee
CALL
FOR INSPECTION
(425)
771-0220
ORIGINAL -FILE YELLOW- INSPECTOR
PINK -OWNER GOLD -ASSESSOR
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171
JUN 09 2004 15:11 FR 0 SHOP 1206 G22 3832 TO WILLIAMS MECH. P.OG
Grease Trap Sizing Wo'rksheet
Facility Name! C9 F e—
Address: 2-2-e2F 10()A__4V,_, W, Suite No.:
• A Grease Trap plumbing permit is required ($165.00 fee). Contact the Pretreatment
Technician (425-672-5755) if you have any questions and also to get signature approval on
this form.
• Dishwashers are not allowed to be connected to a Grease Trap.
• Food disposers are not allowed in a facility served by a Grease Trap and must be disabled or
removed. Solids must be screened out and placed in the solid waste container.
Fixture Capacity in Cubic
Inches
(L x W x D x no. of sinks)
Fixture Capacity
in Gallons
(Cu. In. + 231)
Drainage Load
(75% of Total
Capaci!y)_
Flow Rate for
a 2-Minute
Drain Period
#1
.Z3x23xAx 40r3 c.i.
231 = 26 gal.
x .75 = -Z 0 gal.
. 2 = /C? gpm
#2
X x X c.i.
231 =
.
x.75 =
-
—2= gpm
#3
X X X CA.
_gal.
231 =
__gal.
x.75 =
+2= gpm
#4
x X X c.i.
_gal.
231 = _ gal.
x-.75 =
— 2,= gpm
Greas..� Trap #1 — Total drainage flows from maximum of 4 fixtures
gpin
#1
X X X c.i.
231 = gal.
x.75 = gal.
+2= gpm
#21
x X X c.i.
231 = gal.
x .75 =
gem
#3
x X c.i.
231 = gal.
x.75 = gal.
2 gpm
#4
x c.i.
+ 231 = gal. 1
X.75 =
+2=- gpm
--Pl.
Grease Trap #2 — Total drainage flows from maximum of 4 fixtures
gpm
MINIMUM SIZE OF GREASE TRAP(S) REQUIRED
gpm
— N
I Number of Fixtures Connected to 2 Grease Trap
2—
4
[Grease TrajR Size (in gpm)
Upsize for factors such as high volume dishwashing, high oil/grease content on menu, etc.
----------- City use only below this line)
Remarks: 20 V M, . At . MiA&X� Lt recommenr) ar;Aa 0,
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SizeApproved: 2,0 gpm Approvedby; Date: Y-7-0
Pretmatmet Tedwici�
(Rev. Feb. 2004)
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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 .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR OA-1
OCCUPANCY ..................
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