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DATE RECEIVED
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CITY OF EDMONDS
CON STRUCTION PERMIT APPLICATION
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PROPERTY TAX AdCOUNT PARCEL -NO.
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RESIDENTIAL
PLUMBING MECH
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HEAT SOURCE I GLAZING % I LOT SLOPE %
PLAN CHECK VESTED DATE
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
SEPARATE PERMISSION.
PERMIT APPLICATION: 180 DAYS
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PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 100 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
un 'APPLICANT. ON BEHALF OF HIS OR VIER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
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i IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
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2. EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS F OM ANY AND
cc ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
3: FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT HE
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DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
01 NOR LIMIT IN ANY WAY THE CITY'S ABI1 ITY TO ENFORCE ANY ORDINANCE PROVISION.�
I HEREBY ACKNOWLEDGE THAI I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
T' IE 0 ND TATE LAWS REGULAT114G CONSTRUC-
TION. BY. NO PERSON WILL BE EMPLOYED
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N 0 E OF WASHINGTON RELATING TO
Wo 111�27.
DATE SIGNED
USE
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JOB
ADDRESS
PLAT NAME/SUBDIVISION NO
PERMIT EXPIRES v /
PERMIT
NUMBER
Y"
SUITE/APT#
LOT NO. LID NO,
LID FEE $
TESCP Approved 13
PUBLIC RIGHT OF WAY PER. OFFICIAL STREET MAP
RW Permit Required
13
Street Use Permit Roq'd
E3
EXISTING — PROPOSED
inspection Required
Q
Sidewalk Required
E3
REQUIRED DEDICATION— FT
Underground
Wiring required
E3
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRE ' D
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1ACTOR RESPONSIBLE FOR EROSION CONIROL/DRAINAGE
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FIRE REVIEWED By
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SHORELINE OR ADBI
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SPECIAL INSPECTION JAREA OCCUPANT
LOAD
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REMARKS
PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REQ'D
VALUATION
$
Description
Plan Check
Building Permit
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Fire Inspection
Landscapelnsp.
Recording Fee
FEE Description FEE
State Surcharge
City Surcharge
Base Fee
Plan Chk. Deposit
Receipt #
0
Total Amt. Due All
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
:FiCIAL&.,SIGNArL1)RE - DAT E
I(
/EjSED BY DATE
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
09M PRESS HARD -YOU ARE MAKING 4 COPIES
CALL
FOR INSPECTION
(425)
771-0220
ATTENTION 1 I;JJ;3 (y',
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ORIGINAL - FILE YELLOW . INSPCCTC
PINK - OWNER GOLD - ASSESSOR
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1994 Washington State Nonresidential Energy Code Compliance Forrn
Lighting SuMm'aryi,
1994 Washington State Nonresidential Energy Code Compliance Forms
Second Edition - June 1995
Project Info
ProjeclAddress VUt_1C)tA r-to,-Ffi pt? -Tt�r
Date'4 . 1 �5. C)+
For Building Department Use
Applicant Name:
Applicant Address: 1()1t3 5mewce' ,--T
Applicant Phone: -2 04' - 10 b --�5 - 10 1 F2
!iption New Building U Addition Alteration
Compliance Option Prescriptive LJ Ughting Power Allowance U Systems Analysis
(See Qualification Checklist (over). Indicate Prescriptive & LPA spaces clearly on plans.)
Alteration Exceptions No changes are being made to the lighting
(check appropriate box) Less than 60% of the fixtures are new, and Installed lighting wattage Is not being Increased
IL Ar __! A T Us.- 'TAT�44�,,. ITinfor;nrl
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Location
(floor/room no.)
12 --- 0
Occupancy Description
Allowed
Watts per te
Area in ft"
AJIowed x Am
From Table 15-1 (over) - document all exceptions taken from footnotes Total Allowed Watts
Proposed Lighting Wattage (Interior) (May not exceed Total Allowed Watts for Interior)
Number of
—bon
(floor/room no.)
Fixture Description
Fixtures
Watts/
Fixture
Watts
Prmoposed
Total Proposed Watts may not exceed Total All "w Waft for Interior Total Proposed Wattsi
A 11 - -1 T ! _1L cf- - VAT-"--- 1117-41-: -wl
IV141A LILUJULL r1L11%JVV%;16a
S�A5AL�AQ I I
Allowed Watts
Area In fe
Allowed Watts
Location
Descdption
per fe or per It
-(or If for pedmeter)
x fe (or x If)
Covered Parking
0.2 W/ft'
Open Parking
0.2 W/ft'
Outdoor Areas
0.2 WIte
Bldg. (by facade)
0.25 W/ff2
Bldg. (by pe I r1m) 7.5 W/If
'Watts
Nola: for buildino exterior, choose either the facade area or the perimeter method. but not both) Total Aflowc;j
I v - I- .- __ - VAT_A_k___ If'r-.A. -*--I IKA nni avrYwA Total AllowAd Watts for Exterior)
JL_ JLUFUMCL& A�Ar,&IAAALE,
Location
V
Fixture Description
Number of
Fixtures
Wattst
Fixture
Watts
Proposed
IE
Y i n 9nol.
id Watts
Total ProDosed Watts mav not exceed Total Allowed Watts for Exterior Total pFopi5&
N - 11-14( PERMIT COUNTF.:
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1994 Washington State �oniesldenflal Energy Code Compliance Form
IMm Washington State Nonresideftal Energy Code Compkame Fome
S000nd Edtdon - Am 1995
Other
lPrescriptive Spaces occupancy U Warehouses, storage areas or aircraft storage hangers I
Qualification Checklist
NOW: " occupancy type Is 90thera arW fixture
answer Is chocked, the number of fixtures In
the space is not limited by Code. Clearly
Irxiicate thaso spaces on plans. If not
qualified, do LPA CalcuIallons.
Lighting Fixtures: C] Check here If at least 95% of fixtures In the space meet all four criteria:
1. Fixtures are fluorescent, non -lensed, with only one or two lamps, and
2, Lamps are T-5, T-6, T-8 or PL, and 3. Lamps are 5-50 Watts, and
4. Ballasts are electronic ballasts
Table 15-1 Unit Lighting Power Allowance (LPA) for Interior Lighting
LPA!
LPR
use'
(W/ft)
UMI
(wife)
PaInting, welding, carpentry, machlne shops
2.3
Police and fire stations3
1.2
Beiber shops, beauty shops
2
Atria (atriums)
1
Hotel banquettoonference/exhlbition halp.4
2
Assembly spaces', auditoriums, gymnasia!, tlywlers
1
Laboratories
2
Process plants
Aircraft repair harxiars
1.5
Restaurants/barss
Cafeterias, fast food establishmentso
1.5
Retail A'O
Factories, workshops, handling areas
1.5
Retail B'O, Retail banking
1.5
Gas stations. auto Ir shops"
1.5
Locker andfor shower facilities
0.8
Institutions
1.5
Warehouses", storage areas
0.5
LbmrIW5
1.5
Aircraft storage hangars
0.4
Nursing homes
1.5
Parking garages
wholesale stores (pallet rack shelving)
1.5
Mail concourses
1.4
Pians Submitted for Common Areas Onlyy
Schools buildings, School classrooms, day care centers
1.35
Common ares, corridors, lobbies (except mail Concourse)
0.8
Laundries
1.3
Toilet facilities and washrooms
0.8
Offte buildings, otfliWadministrattve areas In facilities of
other use types (including but not limited to schools,
1.2
,hospitals, lnsfltuftv� museums, banks, churches) 1,7,11
1 -
I I
Footnote$ for Table 15-1
I In cases in which a use is not mentioned specifically, the Unit PowerAUowance 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 exempt areas
2. The watts per square foot may be increased, by two percent per foot of ceiling height above twenty feet, unless specificdly directed
otherwise by subsequent footnotes.
3. Watts per square foot of room may be increased by two percent per foot of cciling height above twelve feet.
4. For all other spaces, such as seating and common areas, use the Unit Light 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 Unit lighting 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 area
and rest rooms. Common areas, as herein defined do not include mall concourses.
8. For the fire engine room, the Unit lighting Power Allowance is 1 .0 watts per square foot.
9. For indoor sport tournament courts with adjacent spectator seating, the Unit Ughtiug Power Allowance for the court area is 2.6 watts per
square foot.
10. For both Retail A and Retail B, light for free-standing display, building showcase illumination and display window illumination installed
within two feet of the window are cxcmpL
Retail A allows a Unit lighting Power Allowance of 1.0 watts per square foot. Cciling mounted adjustable tungsten halogen and HD
merchandise display illuminarics are exempt.
Retail B allows a Unit lighting Power Allowance of 1.5 watts per square foot, including all ceiling mounted merchandise display
luminaries.
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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FINAL PR03ECT APPROVAL FORM
TO:
DATE:
MEMO TO: PE 0 --BurEMNG DIVISION
FROM: FIRE DEPARTMENT DATE 3 /0,.,V
WASE SIGN
ENGINEERING DIVISION DATE
PIXASI: SIGN
PLANNING DIVISION DATE
PLEASE SIGN
PROJECT
SITE ADDRESS -
PERMIT# Q 4a� OZ(ZIZI ADB# DATEINSPECTED
DESCRIPTION OF WORK TO BE INSPECTED
A field inspection Nvas conducted to determine compliance with -approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORAIANCE BONDS and the granting of:
41m) -GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
0 Copy of CONDITIONS given to owner/contrac.tor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
a' Copy of CORRECTION NOTICE given to ow er/. ontractor by hipector
(:-,r/-
LA6 Hr)vu
2. L
3. H—rj,,,r& —Ef
7'_
( 7 let<.
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:tenip:b1dg:forms:ocapr%,1 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 .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
ms
OCCUPANCY ..................
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