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20040517.pdf1�i DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS Z_ LOC MAILING ADDRESS LI z (2-IL 0\101D'Ie. AVIeffu 0 .30 - CITY ZIP TELEPHONE CA OXTVil/:,� I L\JA el 42 5 C�71 v NAME (_uoa ADDRESS M 21 CITY ZIP z-, NAME ADDRESS T V_ >1 , I CITY ZIP STATE LICENSE NUMBER r--LA o (t, I ) C) I (1 0) . PROPERTY TAX ACCOUNT PARCEL NO. , tif - 2�, c, TELEPHONE L CBL Or TELEP�9NE_ e7 1 & t--)g - 6 EX11RATION I I I ) Liz I q NEW RESIDENTIAL f2t k 6 114- ADDITION 60MMERehirt REMODEL MULTIFAMILY �(REPAIFI GRADING CYDS F� DEMOLISH TANK EiGARAGE RETAINING WALL CARPORT ROCKERY (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: /_C_ 11�14_ 9 &Vl NUMBER NUMBER OF OF DWELLING STORIES UNITS Y`\� I DESCRIBE WORK TO BE DONE El PLUMBINU / MECH COMPLIANCE OR OF CHANGE USE SIGN EFENCE I ( _X_ F� OTHER FIRE SPRINKLER FIRE ALARM USE ZONE JOB PDDRESS PLAT N/ I PERMIT EXPIRES PERMIT NUMBER I I U I ��_ a, �, �(�7 11 N NO. I LOT NO. PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING — PROPOSED REQUIRED DEDICATION— FT METER SIZE I LINE SIZE I NO. OF FIXTURES SUITE/APT# LID NO. LID FEE $ TESCP Approved AW Permit Required Street Use Permit Roq'd Inspection Required Sidewalk Required Underground Wiring required )�5, PRV REQUIRED YES 1:1 NO 11 REMARKS OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ENGINEERING REVIEWED BY DATE 0 z z z a z ul FIRE REVIEWED By DATE F I R E R E V I LLI Ir % 0 (� J7 )BY (f OL V A I A N C VARIANCE OR CU R SHORELINE On ADBI INSPECTION BOND BY REO'D I POSTED xe OYES 0 _$ — P SEPA REVIEW S E A SIGN AREA HEIGHT COMPLETE EXEMPT C 0 M P LE T E ALLOWED PROPOSED ALLOWED PROPOSED I 1 0 1 lvk�,) , EXP l,,� E X P LOT COVERAGE LOT C( REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT) ALLOWED ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR wc, MIL, z z PAS K PARKIN G LOT AREA PLANNING REVIEWED BY DATE R EO-D PROVIDED REO-D I itil �� I + T) R M S FT) REMARKS S A*Aj A 6 tiv-z!A Av t 1,1i,,rii L-n ii-iire CRITICAL AREAS NUMBER C5'YeM e 17, ( '0C. - 7a 1 _C3 -3. 0"To - X, -2 . CHECKED BY I TYPE OF CONSTRUCTION CODE OCCUPAN� 76'r-T GRO L*t- SPECIAL INSPECTION AREA OCCUPANT LOAD REQUIRED [j YES REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION R7Ea]'D VALUATION 14,!: r� $ Description FEE Plan Check 116)-7 HE�YOURCE GLAZJNG % LOT §LOPE % 0 1 A///A- A 1- dL Building Permit — PLAN CHECK NO: VESTED DAITE Plumbing Mechanical THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC i DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 180 DAYS PERMIT LIMIT: I YEAR - PROVIDED WORK is STARTED WITHIN 100 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION Grading Engr. Review Engr. Inspection D 2,--IJ 7 � --Pri, ip to Description FEE State Surcharge 1/. �70 City Surcharge 1,4D Base Fee U) 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit W IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF _j ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND 2 EDMONDS, WASHINGTON, Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS FERMI I SHALL NOT BE Due Landscape Insp. Total Amt. DEEMED 10 MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 01 NOR LIMIT IN ANY WAY THE CITYS ABIL11Y TO ENFORCE ANY ORDINANCE PROVISION. - Receipt # Recording Fee I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS CORRECT; AND THAT I AM THE OWNER. OR THE DUL� AUTHORIZED AGENT OF I his application is not a permit until signed by the 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 CALL Building Olficial or his/tier Deputy: and Fees are paid, and IN Vi6LATION OF THE LA13OR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided. WORKMEN'S COMPENSATZ INS . URANCE AND RCW IS 27. OFFICIAtS SIGNATURE DATE SIGNATURE (OWNER Oni 6GENT) t+2 S-_.U_jC:j 16- DATE SIGNED (425) 4117 /h,11 t C, LL 771-0220 REIFA, -D. Y ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 0111GINAL !-gE YELLOW INSPICTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 09,03 PRESS HARD -YOU ARE MAKING 4 COPIES z 0 1 0 M --I -n 0 M C M 0 0 --I (-) 0 M M Z 10--1 C x 0 n > M M 0 0 M C() Cn M 0 Z z Cn z 0 i 0 M N.. MAYESTESTING ENGINEERS, INC. Everett Office 917-134th Street SW Suite A-1 HC Everett, WA 98204 ph 425.742.9360 fax 425.745.1737 MTE No.: Project: E4175 EDMONDS SD EDMONDS ELEM SCHL WALKWAY REPAIRS Tacoma office 10029 S. Tacoma Way Suite E-2 Address: 1215 Olympic Avenue, Edmonds, WA Tacoma, WA 98499 Permit No.: 2004-0517 (City of Edmonds) ph 253.584.3720 fax 253.584.3707 Owner: Edmonds Public Facilities District Portiand office 7911 NE 33rd Drive Architect: R E C E. I V ED suite 190 Engineer: Coughlin Porter Lundeen V, ED �'�E C �E 1 Portland, OR 97211 ph 503.281.7515 contractor: Flag Construction fax 503.281.7579 Page 5 DEVELAki 7_6 2004_4 CITY OF EL)MONuS DEVELOPMENT SERVICES CTR. Date: CITY OF EDMONDS 7/26/04 Weather: Clear Inspection: R/C Sample(s): (4) 6xl 2" Monitored the placement of 2 cubic yards of Glacier mix #3210 at two north columns. Concrete was placed by 5-gallon bucket, and mechanically consolidated. Re -steel was approved prior to placement. Cast (4) 6x12" concrete cylinders for compression strength tests. Slump was 5-1/2" at 831F. To the best of our knowledge, items inspected this date are in accordance with approved plans and specifications. INSPECTOR: Carl Reynolds REVIEWED BY: TTimothyy G. �c�erle, P.E. cc: Nick Chou -Edmonds School District; James E. Coughlin, P.E,-Coughlin Porter Lundeen; Richard Schnell - Flag Construction; Bldg Dept -City of Edmonds z 0 M L/ MAYESTESTING ENGINEERS, INC. G MTE No.: E4175 DS ELEM SCHL WALKWAY REPAIRS Project: EDMONDS SD EDMON Address: 1215 Olympic Avenue, Edmonds, WA Permit No.: 2004-0517 (City of Edmonds) Owner: Edmonds Public Facilities District Architect: Engineer: Coughlin Porter Lundeen Contractor: Flag Construction Page 6 Everett Office 917-134th Street SW Suite A-1 Everett, WA 98204 ph 425.742.9360 tax 425.745.1737 Tacoma office 10029 S. Tacoma Way Suite E-2 Tacoma, WA 98499 ph 253.584.3720 fax 253.584.3707 Portland office 7911 NE 33rd Drive Suite 190 Portland, OR 97211 ph 503.281.7515 fax 503.281.7579 Date: 7/29/04 Weather: N/A Inspection: Epoxy Bolts Sample(s): N/A Onsite for epoxy bolt inspections. Verified epoxy anchors at the upper level SE walkway slab perimeter anchors at east, north and west sides. Anchors at east wall were installed per 13/S3.1, and at north and west walls per 8/S3.1 and 5/S3.1 as plans indicate for the 4x4x3/8" and 6x4xl/2" ledger. The studs at ledger were also verified 1/2x3" at 24" o.c. as per 5/S3.1. Depths verified and holes were brushed and blown clean with compressed air prior to epoxy Simpson SET-22 installation. To the best of our knowledge, items inspected this date are in accordance with approved plans and specifications. INSPECTOR: Rob Emery REVIEWED BY: eckerle, P.E. cc: Nick Chou -Edmonds School District; James E. Coughlin, P.E.-Coughlin Porter Lundeen; Richard Schnell - Flag Construction; Bldg Dept -City of Edmonds z 0 1 0 M -1 -n Ui --I 0 M C= M 0 0 0 0 C: M M Z _Z 0 -n n M M 005 0 r- 0 M C: Cn 9 Ch Q 0 Z ;U z z 0 1 0 M MAYESTESTING ENGINEERS, INC CO CRETE LABORATORY TEST REPQRT Project Edmonds SD Edmonds Elem School Walkwa Project No: E4175 Site Address: 1215 Olympic Ave issued on: 7-30-04 Edmonds,WA Client: Edmonds School District Engineer: Coughlin Porter Lundeen Contractor: Flag Construction Everett office 917 - 134th Street SW Suite A-1 Everett, WA 98204 ph 425.742.9360 fax 425.745.1737 Permit # (s): 2004-0517 original: Revised: FIELD DATA (ASTM C31 and C172) Air Temperature: 70 0 F ActualJ Mix Proportions: Weather: Clear Ingredient Product: Concrete Coarse Aggregate 3/4" Supplier: Glacier Northwest Fine Aggregate Ticket Number: 483310 Water MixDesign ID: 3210 Cement --Type I & 11 7-- t �ri n e d �Xi r dmix A/E A ia r g rSample emp. 631) (A ' 'X�' Temp. (AS� (ASTM C1 064) � 80 0 F NR % ---(ASfM d� 43i 1 �ample(s) Rec—VI lWater/CcnicntRat�ioJ: Sum!) equired St rength cy, 1 0.414 5 i.Placement Location and Notes Building C columns at A.7/4.2 and A.7/4.6 2 gallons of water added to full load on site. Weight (per cu.yd) 2,020.0 lbs 1,340.0 lbs 220.0 lbs 532.0 lbs 3.0 0Z 3000 psi @ 28 days COMPRESS110,14 TEST RESULTS (ASTM C39, C1231, and C617 when applicable) rea Strength (psi) Failure Code Date Made Sample # Lab # Date Tested Age (day) Load (Ibs) Size (in) Dia (in) Surface A T— F4.W F 12.57 1 F 466 07 04 0002 56-i [29/29L E_NK __0_002__1TH68i8/19 1569 E�_ [J:/�2� C26&�F_ 1 2 J EKA 17256 Z—/: i 2 i2 6002 725 ? — --- ____ -_ j ft 6 Remark: Reviewed by: Timothy G. kerle, P.E. Branch Manager Inspector(s): John Chebul Tested by: Scott J Johnson NOTES: Failure descriptions for samples tested with neoprene pads are not required per ASTM Std. - NA = Not Applicable, S = Shear, C = Cone. CSp = Cone and Split, CSh = Cone and Shear, Col = Column FC - Field Cure NR = Not Recorded Information in this report applies only to the actual samples tested and shall not be reproduced without the approval of Mayes Testing Engineers, Inc. MTE Form #150, Rev 3,7.0 Z 0 0 ITI M 1711 0 0 0 0 C 3: M M Z .C) —i _Z C/) 0 -n M 3: M M 0 0 0 M C M 0 Z Z _11 3: W Z 0 1 0 M MAYESTESTING ENGINEERS, INC CONCRETE LABORATORY TEST REPORT Project Edmonds SD Edmonds Elern School Walkwa Project No: E4175 Site Address: 1215 Olympic Ave Issued on: 8-3-04 Edmonds,WA Client: Engineer: Contractor: Edmonds School District Coughlin Porter Lundeen Flag Construction Permit # (s): 2004-0517 Original: RV Revised: R Everett ice 917-134tl StreetSVV Suite A-1 Everett, W '204 11111 425�7�2'9360 fax 425.7 5.1737 FIELD DATA (ASTM C31 and C172) Air Temperature: 80 OF Actual Mix Proportions: Weather: -1 Clear Product: Concrete Ingredient Weight (per c j.yd) Coarse Aggregate 3/4" 2,030.0 lbs Supplier: Glacier Northwest Fine Aggregate 1,305.0 lbs Ticket Number: 483461 Water 225.0 lbs Mix[Design ID: 3210 Cement —Type 1 536.0 lbs Sample Temp. Initial Storage 1 Entrained Air Darair 3.0 0Z L(ASTIVI C1064) I Temp. (ASTIVI C31) I (ASTM C231) 83 0 F NR % Water / Cement Rat mp (ASTM C1 Sample(s) Re 'd L) I §lu Li �J 0.420 5-1/2" 7-27-04 iR—eqWIredStrenVh Cf C)* '1 3000 Psi @ 28 da� IPlacement Location and NoLesj I Two columns at north side. 3 gallons water added on site. COMPRESSION TEST RESULTS (ASTIVI C39, C1231, and C617 when applicable) Date Made Sample # Lab # Date Tested Age (day) Load (Ibs) Size (in) Dia (in) Surface Area Strength (psi) Failure J Figoo 7/26/2004 1 — :FTI 0276F6 x 12 6.00 [=H �7 F NA ---1 U(� XT2 r 7/2-6/2004 0004 1726631-8/23/20041 28 __ — �]= = I EKA --=:� x =,-J= EKA —E:2 2 17/26/2004 �664 8/23/266-4 :1 F - --I 6-L EKA [7i/26 2CO04 06004 172665 0/2004 56 --1-31 1 J=E= Remark: Inspector(s): Carl Reynolds Tested by: Reviewed by: Tom Freeland T�iimothyy G. erle, P.E. NOTES: Failure descriptions for samples tested with neoprene pads are not required per ASTM Std. Branch Manager * NA = Not Applicable, S = Shear, C = Cone, CSp = Cone and Split, CSh = Cone and Shear, Col = Column FC - Field Cure NR = Not Ri Information in this report applies only to the actual samples tested and shall not be reproduced without the approval of Mayes Testing Engineers. Inc. MTE Form �1 50, Rev 3, 7-0 Z 0 A 0 M =i 9 rn ---1 6 M C M 0 0 0 C --4 K X M M Z g) —11 C to -n n M M 0 C—/) 0 r- 0 M C: 0) 9 C/) M 0 Z X Z C/) Z 0 i 0 IT11 0 Everett Office MAYESTESTING ENGINEERS, INC 9 17 - 134th Street SW Suite A-1 Everett, WA 98204 ph 425.742.9360 CONCRETE LABORATORY TEST REPORT fax 425.745.1737 Project Edmonds SD Edmonds Elem School Walkwa Project No: E4175 V Site Address: 1215 Olympic Ave Issued on: 7-27-04 Edmonds,WA Permit # (s): 2004-0517 Client: Edmonds School District Original: Engineer: Coughlin Porter Lundeen Revised: Contractor: Flag Construction FIELD DATA (ASTM C31 and C 172) Air Temperature: 81 OF Mix Proportions: Weather: Partly Cloudy Ingredient Weight (per cu.yd) Product: Concrete Coarse Aggregate 3/4" 2,003.0 lbs supplier: Glacier Northwest Fine Aggregate 1,301.0 lbs Ticket Number: 483178 Water 239.0 lbs MixDesign ID: 3210 Cement --Type 1 528.0 lbs Fs—ampleTemp. — I r initial Storage— Entrained Air Daravair 3.0 0Z (ASTIVI C1 064) 1 Temp. (ASTIVI C31) I (ASTIVI C231) 83 0 F NR % Water / Cement Riiti �- Slump (AST Sample(s) Rec'd 0.453 3-1/2" 7-20-04 ;,�e�qlred Sfr—en6t-h _(fcyl 3000 Psi @ 28 days cement Location and Notes I Four spread footings Building B, A.7/4.2, A.7/4.6, Building C, A.7/4.2, A.7/4.6. Three cubic yards. COMPRESSION TEST RESULTS (ASTM C39, C1231, and C617 when applicable) Area Strength (psi) Failure Code Date Made Sample # Lab # Date Tested Age (day) Load (lbs) Size (in) Dia (in) Surface ____] F_ - ---d- - F408o _3_ff/26/2004 7 F 115360 1 x 12 1[6�661 F28.27 00 E =A -i-4 1 7/19/2004 00021723011 /16/200 28 F —70:0:2::] 723=02 04 0 F------- -1 2 =0 �004 2=8 6 =xl 2 x 12 �7/19/2�004 �600;2��r7 303 1 9/13iiO=O4 Remark: Inspector(s): C.Trip Edgerton Reviewed by: Tested by: Scott J Johnson TimTothy�G. B erle, P.E. Branch Manager NOTES: Failure descriptions for samples tested with neoprene pads are not required per ASTM Std. * NA = Not Applicable, S = Shear, C = Cone, CSp = Cone and Split, CSh = Cone and Shear, Cot = Column FC - Field Cure NR = Not Recorded Information in this report applies only to the actual samples tested and shall not be reproduced without the approval of Mayes Testing Engineers, Inc. MTE Form #150, Rev 3. 7-0 =i =R U) M C ITI 0 0 0 C M M Z C0 0 -n n rn M 0 0 0 M C C/) co Q 0 Z X Z C/) Z 0 1 0 M MAYESTESTING ENGINEERS, INC. MTE No.: E4175 Project: EDMONDS SD EDMONDS ELEM SCHL WALKWAY REPAIRS Address: 1215 Olympic Avenue, Edmonds, WA Permit No.: 2004-0517 (City of Edmonds) Owner: Edmonds Public Facilities District Architect: Engineer: Coughlin Porter Lundeen Contractor: Flag Construction Page 3 Everett Office 917-134th Street SW Suite A-1 Everett, WA 98204 ph 425.742.9360 fax 425.745.1737 Tacoma Office 10029 S. Tacoma Way Suite E-2 Tacoma, WA 98499 ph 253.584.3720 fax 253.5134.3707 Portland Office 7911 NE 33rd Drive Suite 190 Portland, OR 97211 ph 503.281.7515 fax 503.281.7579 Date: 7/20104 Weather: Sunny Inspection: R/S Sample(s): N/A Inspected re -steel for 2 columns on Bldg "B" A.7/4.2 and 4.6, and 2 columns on Bldg "C" A.7/4.2 and 4.6. Re -steel per details 15 and 20/S3.1. Contractor to position (3) #3 ties (once grade is established) at tops of columns. No problems noted. To the best of our knowledge, items inspected this date are in accordance with approved plans and specifications. INSPECTOR: Jesse Kane Date: 7/20/04 Weather: Clear Inspection: Sample(s): Onsite at AAA fab shop in Kent for visual welding inspection in accordance with AWS D 1. 1 -00 specs and shop drawings. Received WABO copy of welder Steve Soderland enclosed. Inspected the following piece marks: 1 C (2), 2A, 2B (12), 2C (2), 2D (2), 2F (2), and 2G (2). Welding is acceptable to code. No problems noted. To the best of our knowledge, items inspected this date are in accordance with approved plans and specifications. INSPECTOR: Mark Vassallo REVIEWED BY: Timothy G.1,Beckerle, P.E. cc: Nick Chou -Edmonds School District; James E. Coughlin, P.E.-Coughlin Porter Lundeen; Richard Schnell - Flag Construction-, Bldg Dept -City of Edmonds z 0 4 0 M ---------- ------------- WABO Ceriltled Welder . . . . . . junuary - March Process qualifications are based on the following standards: -5 llic NAME: Date: STRUCTURAL WELDING SHEET STEEL WELDING ALUMINUM WELDING WABO Standard No.27-13 WASOStandaidNo.28.2 Fze FIRM: --- Title: WABOSUrdlatdNo.27�-13 USCStindaidNo.27-1:1. UBCStandatdNo.27-13 u6C Standard No. 28-1 11 r. 0 .1 CS ANSI/AWS Di.2A.83 April - Jun _12-1 ANSUAWS DIA: 2000 ANSI/AWS 01.3 .98 DIA-98 I— NANIE: Ui'c: ANSYAWS PIRM: --I& July - September SIGNA R F CER IE15 NVELDE R NANIC: ---------- (This card must be signed by the certified welder) Title: rIRSI: ---------- October - December S IGNATURES OF EMPLOYERS Date: DATED by an Emplo)VICuntfactull The section on facing pjvt must be SIGNED and )mned satisfactory Production welder has Perl'i NAME: --------- FIRM: Title: Welder Examiner %ctif) ing that ibis Of the plocess(es) li,ted on the face of this card do ring the quanctlY POW designated ---------- bekow. Falsification (ji'signatures on this card it illegal. Structural Welder �VASIIINGTON ASSOCIATION OF BUILDING OFFICIALS Weldingpiresce". FCAW ht tkd' S 7d-automatic " . e Fit Aplate Posiliolls: F, ' Vertical Progrcsilon: UP 0Xui: Steel F yj)c: E71T-X 4��Ickmejus FLAuge. eover joijit; Groove & BAcklut Requiritill F4411)lele Pcitetration Wcldz? -YA PO Box 7310 - Olympia, WA 98507-7310 Phone: (360) 586-6725 CERTIFIED �N`ELDER CARD STEVE M. SODERLAND Expires: 01APR05 >SOD 84 9665 1838 S 265TH PLACE DES MOINES* WA 98198 This card Is the property of WA130 Cwd mull be renewed on or berate expiration it=. Executive Director 0*1 I 'I Everett Office ENGINEERS, INC. 917-134th Street SW MAYESTESTING Suite A-1 Everett, WA 98204 ph 425.742.9360 fax 425.745.1737 MTE No.: E4175 EDMONDS SD EDMONDS ELEM SCHL WALKWAY REPAIRS Tacoma Office 10029 S. Tacoma Way Project: Suite E-2 Address: 1215 Olympic Avenue, Edmonds, WA Tacoma, WA 98499 Permit No.: 2004-0517 (City of Edmonds) ph 253.5B4.3720 fax 253.584.3707 Owner: Edmonds Public Facilities District Portland Office 7911 NE 33rd Drive Architect: Suite 190 Engineer: Coughlin Porter Lundeen Portland, OR 97211 ph 503.281,7515 Contractor: Flag Construction fax 503.281.7579 Page 4 Date: 7/22/04 Weather: Clear Inspection: R/C Sample(s): (4) 48" Inspected re -steel (from the tops of the forms) and placement of approximately 2 cubic yards of concrete (Glacier mix #3210) at Bldg C columns at A.7/4.2 and A.7/4.6. Concrete was placed by 5-gallon bucket and mechanically consolidated. Verified proper tie locations at the tops of the columns (see inspection report dated 7/20/04 for additional information). To the best of our knowledge, items inspected this date are in accordance with approved plans and specifications. INSPECTOR: John Chebul REVIEWED BY: / �2= -e:ckerle, P.E. Timothy cc: Nick Chou -Edmonds School District; James E. Coughlin, P.E.-Coughlin Porter Lundeen; Richard Schnell - Flag Construction; Bldg Dept -City of Edmonds z 0 4 0 M MAYESTESTING ENGINEERS, INC. IMTE No.: E4175 CHL WALKWAY REPAIRS Project: EDMONDS SD EDMONDS ELEM S Address: 1215 Olympic Avenue, Edmonds, WA Permit No.: 2004-0517 (City of Edmonds) Owner: Edmonds School District RECEIVED Architect: AUG .3 1 20911 Engineer: Coughlin Porter Lundeen Contractor: Flag Construction L)EVELOPMENT . SEFIVj(,�s (-r� Page 7 CITY OF F1,,,i � . , Everett Office 917-134th Street SW Suite A-1 Everett, WA 98204 ph 425.742.9360 fax 425.745.1737 Tacoma Office 10029 S. Tacoma Way Suite E-2 Tacoma, WA 98499 ph 253.584.3720 fax 253.584.3707 Portland Office 7911 NE 33rd Drive Suite 190 Portland, OR 97211 ph 503.281.7515 fax 503.281.7579 Date: 8/9/04 Weather: Clear Inspection: R/C Sample(s): (4) 6xl 2" Inspected reinforcing steel in elevated walkway, Bldg C, SE corner, A-6' to B/4-5, finding it to be as per approved plans and specifications. The contractor placed -8 cubic yards of Glacier NW mix #3210 in this form via line pump, consolidating it with an electric vibrator, and rod and bull float. A sample of this mix was found to have a slump of 5" at 840F, and 3.9% entrained air. Cast (4) cylinders for lab curing and compressive tests. At contractor's request, two cylinders were cast for field curing to test in -situ strength of concrete at 3 and 4 days. To the best of our knowledge, items inspected this date are in accordance with approved plans and specifications. INSPECTOR: Trip Edgerton REVIEWED BY: a"<f f f � Beckerle, P.E. cc: Nick Chou -Edmonds School District; Todd Wood -Coughlin Porter Lundeen; Richard Sc.hnell-Flag Construction; Bldg Dept -City of Edmonds z 0 1 0 M --I -n M rn 0 __10 0 C rn M Z JO -q C co 0 _n n -4 X-C rn M 065 0 r- 0 m C CD 9 CD M 0 Z z Cn z 0 q 0 M Everett office TESTING ENGINEERSy INC. 917-134th Street SW MAYES Suite A-1 Everett, WA 98204 ph 425.742-9360 lax 425.745.1737 Tacoma office MTE No.: E4175 10029 S. Tacoma Way EDMONDS SD EDMONDS ELEM SCHL WALKWAY REPAIRS E-2 Project: Suite Address: 1215 Olympic Avenue, Edmonds, WA Tacoma, WA 98499 Permit No.: 2004-0517 (City of Edmonds) ph 253.584.3720 fax 253.584.3707 Portland office Owner: Edmonds School District 7911 NE 33rd Drive Suite 190 Architect: Portland, OR 97211 Engineer: Coughlin Porter Lundeen ph 503.281.7515 z 0 Contractor: Flag Const ruction fax 503.281-7579 0 Page 8 M Date: 8/12/04 Cn Weather: M C M Inspection: Epoxy 0 0 0 Sample(s): N/A C Epoxy bolt inspections continue durin g construction for walkway from east parking lot. Verified M M z epoxy bolt installations, hole depths at NE side bolt for (6) 5/8" bolts, and (2) 3/4" bolts that were ledger at brick wall and south side C 2 > installed for ledger angle support at east concret e wall, north tube steel walkway for NE supporting beam with 4 studs per plans. :C Simpson Strong -Tie SET-22 Epoxy w as used at the holes after brush, blown clean per 0 -n -n specifications. M M To the best of our knowledge, items inspected this date are in accordance with approved plans 0 U; 0 r- and specifications. INSPECTOR: Rob Emery 0 M C Cn Q 0 Z z 3: C/) z 0 M REVIEWED BY: Timothy G. Beckerle, P.E. Nick Chou -Edmonds School District; Todd Wood -Coughlin Porter Lundeen; Richard Schnell -Flag C onstruction; cc: Bldg Dept -City of Edmonds Everett office MAYESTESTING ENGINEERS, INC. 917-134th Street SW Suite A-1 slip Everett, WA 98204 ph 425.742.9360 fax 425.745.1737 MTE No.: E4175 Tacoma Office Project: EDMONDS SD EDMONDS ELEM SCHL WALKWAY REPAIRS 10029 S. Tacoma Way Suite E-2 Address: 1215 Olympic Avenue, Edmonds, WA Tacoma, WA 98499 Permit No.: 2004-0517 (City of Edmonds) ph 253.584.3720 fax 253.584.3707 Portland Office Owner: Edmonds School District 7911 NE 33rd Drive suite 190 Architect: Engineer: Coughlin Porter Lundeen Portland, OR 97211 ph 503.281.7515 Contractor: Flag Construction fax 503.281.7579 Page 9 Date: 8/18/04 Weather: Sunny,830F Inspection: R/S, Concrete Sample(s): (6) 48" Checked re -steel this morning for the north side elevated walkway prior to placement of concrete. Returned in the afternoon and observed as corrections were made as needed prior to placement. Observed and sampled concrete during placement of 8 cubic yards of Glacier mix #3210 placed by pump and consolidated by vibration. Slump was 4" at 800F. Cast (4) 48" cylinders for lab - cure compliance tests for 3000 psi, and cast (2) 48" cylinders for field cure for form removal data. The engineer assigned from CPL Engineering, Todd Ward, P.E., also toured the site this afternoon prior to placement. No discrepancies noted. To the best of our knowledge, items inspected this date are in accordance with approved plans and specifications. INSPECTOR: Lonny Morrison REVIEWED BY: T�imothy. e�ckerle, P.E. cc: Nick Chou -Edmonds School District; Todd Wood -Coughlin Porter Lundeen; Richard Schnell -Flag Construction; Bldg Dept -City of Edmonds z 0 1 0 M =i =6 Everett Office MAYESTESTING ENGINEERS, INC 917 - 134th Street SW Suite A-1 Aar- Everett, WA 98204 ph 425.742.9360 CONCRETE 1ABORATORY TEST REPORT tax 425.745.1737 Project Edmonds SD Edmonds Elem School Walkwa Project No: E4175 Site Address: 1215 Olympic Ave Issued on: 8-17-04 Edmonds,WA Permit # (s): 2004-0517 Client: Edmonds School District Original: Engineer: Coughlin Porter Lundeen Revised: Contractor: Flag Construction FIELD DATA (ASTM C31 and C172) Air Temperature: 81 OF Actual Mix Proportions: Weather: Partly Cloudy ingredient Weight (per cu.yd) Product: Concrete coarse Aggregate 3/4" 2,003.0 lbs Supplier: Glacier Northwest Fine Aggregaie 1,301.0 lbs Ticket Number: 483178 Water 239.0 lbs MixDesign ID: 3210 Cement --Type 1 528.0 lbs - - �j F-le - f �_&n_n - . (ASTMC1064) Initial St-o-rage --bin—traineii-AiF I Temp.(ASTMC31) (ASTM 231) Daravair 3.0 0Z 830F NR % 0.453 3-1/2" 7-20-04 3000 Psi@ 28 days :Placement Location and Notes I Fou - r spread footings Building B, 77/4.2, A.7/4.6, Building C, A-7/4.2, A.7/4.6. Three cubic yards. COMPRESSION TEST RESULTS Date Made (ASTM C39, C1231, and C617 when applicable) si) Sample # Lab # Date Tested Age (day) Load (lbs) Size (in) Dia (in) Surface Area Strength (p Failure Code _�A 7 J_ _000i. �-l-'f23-001-f/2-6/-i6O-4-]----� 90 6 6.001 6�ff -1 6 [4b8 F i�_3 0-11-8- /_1 - 6798-0 6 T2 0-0-4 2 8 1 �5920_ 15/:i�Q 4 -1-iV,11 _J76� 6xii 1 66601 - ------ 00-02 �8 __6 x i-28.37 NA`__J Remark: Inspector(s): C.Trip Edgerton _4� Reviewed by: Tested by: Scott J Johnson Timothy G. B kerle, P.E. i th�64 Branch Manager NOTES: Failure descriptions for samples tested with neoprene pads are not required per ASTM Std. ' NA = Not Applicable, S = Shear, C = Cone, CSp = Cone and Split, CSh = Cone and Shear, Col = Column FC - Field Cure NR = Not Recorded Information in this report applies only to the actual samples tested and shall not be reproduced without the approval of Mayes Testing Engineers, Inc. IVITE Form 050, Rev 3, 7.0 Z 0 i 0 M =i 9 0 M C M 0 0 0 0 C:: 4 K X M M Z r') 11 C: 0) 0 -n n M M 0 0 1711 C C/) 9 Cn Im 0 Z Z -1 X C/) Z 0 1 0 171 0 MAYESTESTING ENGINEERS, INC CONCRETE LABORATORY TEST REPORT Project Edmonds SD Edmonds Elern School Walkwa Project No: E4175 Site Address: 1215 Olympic Ave Issued on: 8-20-04 Edmonds,WA Permit # (s): 2004-0517 Client: Edmonds School District Original: EV] Engineer: Coughlin Porter Lundeen Revised: 7 Contractor: Flag Construction Air Temperature: 70 OF Weather: Clear Product: Concrete Supplier: Glacier Northwest Ticket Number: 483310 MixDesign ID: 3210 FIELD DATA (ASTIVI C31 and C172) Mix Proportions: i Sample Temp. InItialStorage __Efrn_tra_inedAir (ASTIVI C1064) I Temp. (ASTIVI C31) (ASTIVI C231) Everett Office 917 - 134th Street SW Suite A-1 Everett, WA 98204 ph 425.742.9360 fax 425.745.1737 Ingredient Weight (per cu.yd) Coarse Aggregate 3/4', 2,020.0 lbs Fine Aggregate 1,340.0 lbs Water 220.0 lbs Cement --Type I & 11 532.0 lbs A/E Admix 3.0 0Z 80 0 F NR % ,W-ater/ Cement Ratio: Slum (ASTM_6i__ ample(s) Ree'd 0.414 5 !Requi 3000 Psi @ 28 days _Placern�nt Location and Notes Building C columns at A.7/4.2 and A.7/4.6 2 gallons of water added to full load on site. COMPRESSION TEST RESULTS (ASTM C39, C1231, and C617 when applicable) Date Made Sample # Lab # Date Tested Age (day) Load (lbs) size (in) Dia (in) Surface Area Strength (psi) Failure Code ---------- 7/22/2004 0002 72 314 F i F, 51070 x 8_14-001 r 0 i NA 0,� 90 7/2212004 L 001 !004 -.--.-4 x 8 F 5580 NA __7 — -6—oo2 E772-5-691-8i-19/2o6�1_�8 4 x 8 4 7�1�6 F7/22/2004 72320 ___q730 NA 8- 4.01 ___12.63 L574P NA 1 7/22/2004 70 18/19/2004 iF 36 Remark: Inspector(s): John Chebul _tkerle, P.E. Tested by: Scott J Johnson Reviewed by: t7 �v Timothy G. Branch Manager NOTES: Failure descriptions for samples tested with neoprene pads are not required per ASTM Std. * NA = Not Applicable, S = Shear, C = Cone, CSp = Cone and Split, CSh = Cone and Shear, Col = Column FC - Field Cure NR = Not Recorded information in this report applies only to the actual samples tested and shall not be reproduced without the approval of Mayes Testing Engineers, Inc. MTE Form #150. Rev 3, 7.0 Z 0 1 0 M =i :5 US --i 3: 0 M C: M0 0 —1 0 0 C 4 Z_ 3: M M Z IC) --I C _Z X U) 0 -n n M M 0 0 0 M C CD 9 Cn Q 0 Z r- Z Z 0 1 0 M a MAYESTESTING ENGINEERS, INC Everett Office 9 17 - 134th Street SW Suite A-1 Everett, WA 98204 Ph 425.742.9360 CONCRETE LABORATORY TEST REPORT fax 425.745.1737 P roject Edmonds SD Edmonds Elem School Walkwa Project No: E4175 Site Address: 1215 Olympic Ave Issued on: 8-17-04 Edmonds,WA Permit # (s): 2004-0517 Client: Edmonds School District Original: OV Engineer: Coughlin Porter Lundeen Revised: 0 Contractor: Flag Construction FIELD DATA (ASTM C31 and C172) Air Temperature: 86 0 F Mix Proportions: Weather: Clear Ingredient Weight (per cu.yd) Product: Concrete Coarse Aggregate 1,935.0 lbs Supplier: Glacier Northwest Fine Aggregate 1,256.0 lbs Ticket Number: 561272 Water 240.0 lbs Mix[Design ID 3210 Cement --Type 1 516.0 lbs 1__fii_iViaIStorage1 FS6_6iple Temp. I EntrainedAir Daravair 3.0 0Z (ASTIVI Temp. (ASTIVI C31) I (ASTIVI C231) 84 0 F NR % [W�t�-rl —Cel;-�nt —Ratio. -1 Ci4-3)1 � Emple(s) A u _ieng 0.465 511 8-10-04 _jLe� [Fed §t —fh—( 3000 Psi@ 28 days Placernent Location and Notes Elevated walkway Building C, southeast corner. A-6 to B/4 to 5. COMPRESSION TEST RESULTS (ASTM C39, C1231, and C617 when applicable) Date Made Sample # Lab # Date Tested Age (day) Load (lbs) Size (in) Dia (in) Surface Area Strength (psi) Failure Code _�3328 8/12/2004 =P00 8.27 6/9T�004 7 2170 =NA _.QP05-FC —1-9/1 �/�QC47r I OC4 �QQA!L- �FC 8 7 �2 _�3�29 L� A ,:8/�/ 0 85800 �/9/200,e�17[�0=05�-Td _LI-8-/-16/2-0-04-1-7 _Q_] NA _-LE3:i �/ �/Z�C4 0005 6/6/�664 278 0005 J x 12 9/6/2004 [�24]= -005 _7j3_3 5 x ii i;p0_ 33 0/4/200� ---6_] NA Remark: Inspector(s): C,Trip Edgerton Tested by: Scott J Johnson Reviewed by: J Timothy G. B erle, P.E. Branch Manager NOTES: Failure descriptions for samples tested with neoprene pads are not required per ASTM Sid. * NA = Not Applicable, S = Shea'r, C = Cone, CSp = Cone and Split, CSh = Cone and Shear, Col = Column FC - Field Cure NR = Not Recorded Information in this report applies only to the actual samples tested and shall not be reproduced without the approval of Mayes Testing Engineers, Inc. MTE Form #150, Rev 3, 7-0 Z 0 M M C M 0 __10 0 C M M Z C o -n n - i 3:9 M M 0 —C/) 0 r- 0 M cl) co M 0 Z Z 0) Z 0 M 9 MAYESTESTING ENGINEERS, INC Everett Office 917 - 134th Street SW Suite A-1 Z Everett, WA 98204 ph 425.742.9360 CONCRETE LA130RATORY TEST REPORT fax 425.745.1737 Project Edmonds SD Edmonds Elem School Walkwa Project No: E4175 Site Address: 1215 Olympic Ave Issued on: 8-16-04 Edmonds,WA Permit# (s): 2004-0517 Client: Edmonds School District Original: Engineer: Coughlin Porter Lundeen Revised: Contractor: Flag Construction FIELD DATA (ASTIVI C31 and C172) Air Temperature: 86 0 F Mix Proportions: Weather: Clear Product: Concrete Ingredient Weight (per cu.yd) Coarse Aggregate 1,935.0 lbs Supplier: Glacier Northwest Fine Aggregate 1,256.0 lbs Ticket Number: 561272 Water 240.0 lbs MixDesign ID: 3210 Cement —Type 1 516.0 lbs Sample Tern 'Initial ' E trained Air p. Storage I n Daravair 3.0 0Z (ASTIVI C1 064) Temp. (ASTM C31) I (ASTIVI C231) 840 F NR % F��rr ipl i �(s) e e d Water/ Cement. Ratio: I Slump(ASTIVIC143) T� 0.465 5" 8-10-04 [R:i�qk_ecit_tr�r_i_gfh _(fc)--`1 3000 Psi@ 28 days fl—acement Location and Notes I MENEEMMOMEMMMEMMM" Elevated walkway Building C, southeast corner. A-6 to B/4 to 5. COMPRESSION TEST RESULTS (ASTIVI C39, C1231, and C617 when applicable) Date Made Sample # Lab # Date Tested Age (day) Load (Ibs) Size (in) Dia (in) Surface Area Strength (psi) Failure Code 8/9/2004 1 0005-FC 73328 12/20041* 3 il 2�� --I-- __Q_1 - 1:6 x [� �17U �A 8/9/2004 1_6006-_�C 73329 8/13 4-- 69930 1 6� q. �01 - F�ktl E2TT79 1-00-05--F—C-�-73-33—O—F8/—li�/-20-0,�-1---- F----'— 1_6_x_1-i1= F____ 1-= F 2004 000 73-3--3— F R/2064 —1 — - 7=0 fi—b Lp_v�9/2004_ ___6005 1:211= NA — __ GJ 2004 -1 J __Q90� 7qN3 __q__ Remark: Inspector(s): C.Trip Edgerton Tested by: Scott J Johnson Reviewed by: T i_�mo ith y—G. k e r I e, P. E. NOTES: Failure descriptions for samples tested with neoprene pads are not required per ASTIVI Std. Branch Manager * NA = Not Applicable, S = Shear, C = Cone, CSp = Cone and Split, CSh = Cone and Shear, Col = Column FC - Field Cure NR = Not Recorded Information in this report applies only to the actual samples tested and shall not be reproduced without the approval of Mayes Testing Engineers, Inc. MTE Form #150. Rev 3, 7-0 Z 0 A 0 M q =-n 3: M M 0 0 C: --i K 3: M ITI Z 0-4 C _Z W 0 -n n M M 055 0 r- 0 M C Cn 9 C/) Q 0 Z X Z Z 0 A 0 M 9 Everett Office MAYESTESTING ENGINEERS, INC 917 - 1341h Street SW Suite A-1 7j" Everett, WA 98204 ph 425.742.9360 CONCRETE LABORATORY TEST REPORT fax 425.745.1737 Project Edmonds SD Edmonds Elem School Walkwa Project No: E4175 Site Address: 1215 Olympic Ave Issued on: 8-13-04 Edmonds,WA Permit # (s): 2004-0517 Client: Edmonds School District Original: 9 Engineer: Coughlin Porter Lundeen Revised: El Contractor: Flag Construction FIELD DATA (ASTM C31 and C172) Air Temperature: 86 OF Actual Mix Proportions: Weather: Clear Ingredient Weight (per cu.yd) Product: Concrete Coarse Aggregate 1,935.0 lbs Supplier: Glacier Northwest Fine Aggregate 1,256.0 lbs Ticket Number: 561272 Water 240.0 lbs MixDesign ID: 3210 Cement —Type 1 516.0 lbs _1 I — — 3.0 0Z FS—ample Temp. Initial Storage 11 ffn—trained A r Darovair (ASTM C1064) I Temp. (ASTM C31) I (ASTM C23J) 84 0 F NR % Slump (ASTM-_C143)-f—Ija� �plii(s) Reed'i 0.465 51 8-10-04 [Re 3000 Psi @ 28 days :qul�ed Streii6t�a�, ocation and Notes I Elevated walkway Building C, southeast corner. A-6 to B/4 to 5. COMP (ASTM C39, C1231, and C617 when applicable) rea Strength (psi) Failure Code Date Made Sample # Lab # Date Tested Age (day) Load (Ibs) size (in) Dia (in) Surface A J x �12 ]F6.601 F 8.27 1 [ZlL79_1 r NA - ____1_6_66_5-FC ]Tf3i8 [LCI E L12 0 0 4 EN =A - 8/9/2004 73329 goo4=r _q C13 4 99ib __28___ _x=1 2 6.61 F .37 i �O4 6005-FC Ff3737RQ:i 7 F_ _Xx1 Zl= 14A J_ NA F-6/9/2004 1 0005 173331 � �&/2004 x 12 0005 73332 9/6/2004 E= 8/9/2004 _5� =A a/C/2004 3 10/4/2 --I_ - �Q04J:176L =_ Remark: Inspector(s): C.Trip Edgerton Reviewed by� Tested by: Scott J Johnson Timothy G. Beckerle, P.E. Branch Manager NOTES: Failure descriptions for samples tested with neoprene pads are not required per ASTM Sid. * NA = Not Applicable, S = Shear, C = Cone, CSp = Cone and Split, CSh = Cone and Shear, col = Column FC - Field Cure NR = Not Recorded information in this report applies only to the actual samples tested and shall not be reproduced without the approval of Mayes Testing Engineers, Inc. MTE Form 0150, Rev 3, 7.0 Z 0 0 Ri q U5 0 M C: M 0 __10 0 3: M M Z C/) o -n n M M 0 U5 01- 0 M C Cn 9 co ITI 0 Z Z 0) Z 0 'I 0 IT! I ),a --Dooq -0s) -1 1 MAYESTESTING ENGINEERS, INC. MTE No.: E4175 I Project: EDMONDS SD EDMONDS ELEM SCHL WALKWAY REPAIRS Address: 1215 Olympic Avenue, Edmonds, WA Permit No.: Pending (City of Edmonds) Owner: Edmonds Public Facilities District Architect: R F C E: I'VE D Engineer: Coughlin Porter Lundeen Contractor: Flag Construction Page 1 (',�rai�i,:,.I,IT SERViCES r1TR Or AV Everett Office 917-134th Street SW Suite A-1 Everett, WA 98204 ph 425.742.9360 fax 425.745.1737 Tacoma Office 10029 S. Tacoma Way Suite E-2 Tacoma, WA 9B499 ph 253.584.3720 fax 253.584.3707 Portland Office 7911 NE 33rd Drive Suite 190 Portland, OR 97211 ph 503.281.7515 fax 503.281.7579 Date: 7/16/04 Weather: Clear Inspection: Soils Sample(s): N/A Onsite to verify soil bearing condition at new concrete column footings. Contractor has excavated concrete footings down to native dense gravelly sand. The required 2000 psf bearing require- ment shown on structural cover sheet was verified by visual observation and probing. Reviewed project scope and inspected requirements with project superintendent, Victor. To the best of our knowledge, items inspected this date are in accordance with approved plans and specifications. INSPECTOR: Tom Cain REVIEWED BY: / f,'im9,ihy G. Beckerle, P.E. cc: Nick Chou -Edmonds School District; James E. Coughlin, P.E.-Coughlin Porter Lundeen; Richard Schnell - Flag Construction; Bldg Dept -City of Edmonds z 0 i 0 M =i rn- P4 MAYESTESTING ENGINEERS, INC. MTE No.: E4175 Project: EDMONDS SD EDMONDS ELEM SCHL WALKWAY REPAIRS Address: 1215 Olympic Avenue, Edmonds, WA Permit No.: Pending (City of Edmonds) Owner: Edmonds Public Facilities District Architect: Engineer: Coughlin Porter Lundeen Contractor: Flag Construction Page 2 �300q _01SIl Everett Office 917-1341h Street SW Suite A-1 Everett, WA 98204 ph 425.742.9360 fax 425.745.1737 Tacoma Office 10029 S. Tacoma Way Suite E-2 Tacoma, WA 98499 ph 253.584.3720 fax 253.584.3707 Portland office 7911 NE 33rd Drive Suite 190 Portland, OR 97211 ph 503.281.7515 fax 503.281.7579 Date: 7/19/04 Weather: Pt Cloudy Inspection: R/C Sample(s): (4) 6x12" Inspected reinforcing steel in excavated holes for 4 spread footings at the following locations: • Bldg B — A.7/4-2, 4.6 • Bldg C — A.7/4.2, 4.6 proved plans and specifications, except #5 bars were used Reinforcing was found to be as per ap instead of specified #4 bars. The contractor placed less than 3 cubic yards of Glacier NW mix #3210 in these forms via wheelbarrow, consolidating it with manual vibration. A sample was found to have a slump of 3-1/2" at 830F. Cast 4 cylinders for lab curing and analysis. To the best of our knowledge, items inspected this date are in accordance with approved plans and specifications. INSPECTOR: Trip Edgerton REVIEWED BY: T1 0 G. Beckerle, P.E. Ix cc: Nick Chou -Edmonds School District; James E. Coughlin, P.E.-Coughlin Porter Lundeen; Richard Schnell - Flag Construction; Bldg Dept -City of Edmonds z 0 i 0 M 0 Everett Office MAYESTESTING ENGINEERS, INC R E C E� 'A V E [At 7 - 134th Street SW Suite A-1 _17-P Everett, WA 98204 ph 425.742.9360 ? 2004 fax 425.745.1737 CONCRETE LABORATORY TEST REPORT ULVtLUF,N,1 VICU G f F. Project Edmonds SD Edmonds Elem School Walkwa Project Site Address: 1215 Olympic Ave Issued on: 8-24-04 Edmonds,WA Permit#(s): 2004-0517--f0pwxo,5 Client: Edmonds School District Engineer: Coughlin Porter Lundeen Contractor: Flag Construction Original: F./_1 Revised: FIELD DATA (ASTM C31 and C172) Air Temperature: 80 OF Actual Mix Proportions: Weather: Clear Product: Concrete Ingredient Weight (per cu.yd) Coarse Aggregate 3/4" 2,030.0 lbs Supplier: Glacier Northwest Fine Aggregate 1,305.0 lbs Ticket Number: 483461 Water 225.0 lbs MixDesign ID: 3210 Cement --Type 1 536.0 lbs Sample Te Initial Storae m P. ia Entrained Air Darair 3.0 0Z (ASTMC1064) Temp.(ASTIVI 31) (ASTMC231) femp. TM C 830F NR % Slump (ASTIVI C143) 1 V (s) F�e_c'd 0.420 5-1/2" 7-27-04 [ �equired 3000 Psi @ 28 days lacement Location and Notes I mood Two columns at north side. 3 gallons water added on site. COMPRESSION TEST RESULTS (ASTM C39, C1231, and C617 when applicable) Date Made Sample # Lab # Date Tested Age (day) Load (lbs) Size (in) Dia (in) Surface Area Strength (psi) Failure Code ZT�6/2=004 0004 F726621 C/212004 1 7 27o 1: =6x 1=2 F6. 6 ol F 28.27 39=00 [ 7/2:6:/=2004 0�004 �7ZI36fl =8/Z3/2004 E154570 2IF5.991 F H. 18 5 4=9 0 [ L7/26/2004 0 0:0 =4 _�4:1 8/23/2004-1 Fi�6340 7 2=6 =28.1 =7/2—§/26—p4 [::o�o64 �72�qp�58/23/204128 IF —i57500 6 x 12 =28.1 :8 0:] A:] Remark: Inspector(s): Carl Reynolds Tested by: Scott J Johnson Reviewed by: /-1- /17 9,c,� TrTimo—t y--&. —Bc—rle, P.E. Branch Manager NOTES: Failure descriptions for samples tested with neoprene pads are not required per ASTM Std. * NA = Not Applicable, S = Shear, C = Cone, CSp = Cone and Split, CSh = Cone and Shear, Col = Column FC - Field Cure NR = Not Recorded Information in this report applies only to the actual samples tested and shall not be reproduced without the approval of Mayes Testing Engineers, Inc. MTE Form # 150, Rev 3, 7.0 Z 0 0 M -n M M 0 0 C --I K X M M Z JO --i C (J) o -n n M M 0 0 0 M C cl) 9 Cn M 0 Z X Z --I M 0) Z 0 i 0 M 0 MAYESTESTING ENGINEERS, INC CONCRETE LABORA rOR V TEST REPORT Project Edmonds SD Edmonds Elem School Walkwa Project NO: Site Address: 1215 Olympic Ave Issued on: Edmonds,WA Permit # (s): Client: Edmonds School District Original: R Engineer: Coughlin Porter Lundeen Revised: El Contractor: Flag Construction Everett Office 917 - 134th Street SW Suite A-1 Everett, WA 98204 ph 425.742.9360 fax 425.745.1737 E4175 8-26-04 2004-0517 FIELD DATA (ASTM C31 and C 172) Air Temperature: 83 OF Actual ]Mix Proportions: Weather: Sunny Ingredient Weight (per cu.yd) Product: Concrete Coarse Aggregate 3/4" 1,933.0 lbs Supplier: Glacier Northwest Fine Aggregate 1,269.0 lbs Ticket Number: 593614 Water 175.0 lbs MixDesign ID: 3210 Cement --Type I & 11 518.0 lbs Sample Temp. initial Storage-1 Entrained Air (ASTM C1064) Temp. (ASTIVI C31)1 (ASTIVI C231) 800 F NR % 'd [Iqa-,e-r-/ C-cment Ratio: mp (ASTM iW3—)l ISample(s) Rec'd 0.338 411 8-19-04 FR—equFre-T—S 3000 Psi @ 28 days Placement Location and Notes North side elevated walkway. COMPRESSION TEST RESULTS (ASTM C39, C1231, and C617 when applicaDle) Date Made Sample # Lab # Date Tested Age (day) Load (Ibs) Size (in) Dia (in) Surface Area Strength (p sl) Failure Code 0006-FC 73665 8/21 F 12.66 [:Q/1 R064 2004 �]CEE82��3_0[::� x =8F4-02 __;��=20 _ =NA 5 x8 F 12.63 18/18/2004 0006-FC 8/23/2004 3650Q E��89Q_ N _�_36 [ 8/18/E2:0:04:] (000=6 671_6j2_5/200�__=1 42890 4 F� =4 OP 4 T1 5i2OO4 �xTl= E_= 9/1,1 Ll 0006 8 — _L73668] - __6_] A =x8 F-8/18/2004T 0006 [73669 0_�42 8 JE T 0006 173670 LA =X8 �2094 J_ — 9/15/2004 28 E: =NKI Remark: Inspector(s): Lonny Morrison Reviewed by: 7- Tested by: Scott J Johnson T t imotihy G. e kerle, P.E. Branch Manager NOTES: Failure descriptions for samples tested with neoprene pads are not required per ASTM Std. * NA = Not Applicable, S = Shear, C = Cone, CSp = Cone and Split, CSh = Cone and Shear. Col = Column FC - Field Cure NR = Not Recorded information in this report applies only to the actual samples tested and shall not be reproduced without the approval of Mayes Testing Engineers, Inc. MTE Form 10M, Rev 3, 7-0 Z 0 1 0 M =i =6 Cl) 0 M C: M 0 0 0 0 C M ITI Z C _Z r 0 _n Ti __I M K M M 0 —C/) 0 r- I 0 ITI cl) CO) M 0 Z Z Z 0 1 0 ITI a Everett Office MAYESTESTING ENGINEERS, INC 917 -134th Street SW Suite A-1 Everett, WA 98204 pit 425.742.9360 CONCRETE LABORATORY TES 7 REPORT fax 425.745.1737 Project Edmonds SD Edmonds Elern School Walkwa Project No: E4175 Site Address: 1215 Olympic Ave Issued on: 8-24-04 Edmonds,WA Permit # (s): 2004-0517 Client: Edmonds School Distri ct Original: 21 Engineer: Coughlin Porter Lundeen Revised: 1771 Contractor: Flag Construction FIELD DATA (ASTIVI C31 and C172) Air Temperature: 83 OF Actual Mix Proportions: Weather: Sunny ingredient Weight (per cu.yd) Product: Concrete Coarse Aggregate 3/4" 1,933.0 lbs Supplier: Glacier Northwest Fine Aggregate 1,269.0 lbs Ticket Number: 593614 Water 175.0 lbs MixDesign ID: 3210 Cement --Type I & 11 518.0 lbs Temp Initial Storage Entrained Air =Sample (ASTMC1064�) Temp.(ASTMC31) (ASTIVIC231 www�_ 80 0 F NR % —Ccmen Fsl ump (ASTM (3143�jl Sample(s) R"I FWa—tcr / t 4" 8-19-04 [�_�_qTired '�Strength �VcY� 3000 psi @ 28 days 0.338 Placement Location and N at. �s North side elevated walkway. COMPRESSION TEST RESULTS Date Made (ASTM C39, C1231, and C617 when applicable) psi) Sample # Lab # Date Tested Age (day) Load (lbs) Size (in) Dia (in) Surface Area Strength -6_2� F —1-2.69-1 Failure Code — =8/1 8/200=4 0006-FC 2-- =3 8230 F4-. E��7366�5:�8/ 1/20041 —1 18/23/2004 1 5 1 L ��Q 4 =x8 F�oi I F 12.63 &A [:8/:1=8/2::o�040006-FC 004 r8L/ 18 / �2 173666 __��b_bUl �00�06 4 x 8 -i3667 I 8/25./=2004= 58�� — ?U[__E�: 8 6 E7:3 6::6: �BJ —9/ 15 x= R000 _1 E-1 9/15L2004 -NA 3669 F8/1=8/20=04=000=6J:7=:T - — I I. X8 J10 [:8=/18/:2:0:0:4=0006 LTq670 5/2004 1 28 1 ---] E F.. Remark: Inspector(s): Lonny Morrison Tested by: Scott J Johnson -_ - Reviewed by: -7/ E. Timothy�& c erle, P Branch Manager NOTES: Failure descriptions for samples tested with neoprene pads are not required per ASTM Std. * NA = Not Applicable, S = Shear, C = Cone, CSp = Cone and Split, CSh = Cone and Shear, Col ,-- Column FC - Field Cure NR = Not Recorded Information in this report applies only to the actual samples tested and shall not be reproduced without the approval of Mayes Testing Engineers. Inc. MTE Form #150. Rev 3, 7-0 Z 0 :; M C M 0 0 0 C: M M Z JO --I cl) o -n n M M 0 50 0 r- 0 M C Cn 9 C/) M 0 Z X Z --I X W Z 0 1 0 IT! 109 MAYESTESTING ENGINEERS, INC. Everett Office 917-134th Street SW Suite A-1 Everett, WA 98204 ph 425.742.9360 September 8, 2004 fax 425.745.1737 Tac6ma Office 10029 S. Tacoma Way City of Edmonds Building Department VID JA'G Suite E-2 Tacoma, WA 98499 253.584.3720 121 5th Avenue N ph fax 253.584.3707 Edmonds, WA 98020-3146 Portland Office 7911 NE 33rd Drive Suite 190 Attn.: Building Official Portland, OR 97211 ph 503.281.7515 tax 503.281.7579 Re: Edmonds SD Edmonds Elementary School FINAL LETTER Walkway Repairs Permit # 2004-0517 1215 Olympic Avenue Edmonds, WA MTE Project No. E4175 Gentlemen, This is to inform you that registered special inspections have been completed for this project as per our reports, copies of which have been sent to you. To the best of our knowledge, all work inspected was either performed in accordance with, or corrected to conform to, the city approved drawings, or engineer approved changes. Special inspection was provided for: Soil Bearing Verification Reinforced Concrete Epoxy Anchors Structural Steel Fabrication We trust that this provides you with the information which you require. Should you have any cluestions give us a call. Sincerely, MAYES TESTING ENGINEERS, INC. Timothy GLE(eckerle, P.E. Branch Manager Cc: Nick Chou — Edmonds School District Devone Miles -Edmonds School District Todd Wood- Coughlin Porter Lundeen Richard Schnell -Flag Construction TGB:rsm ff� z 0 4 0 M a BUILDING Everett Office MAYESTESTING ENGINEERS, INC Q 17 - 134th Street SW SEP 2 1 2004 Suite A-1 Everett, WA 98204 ph 425.742.9360 CONCRETE LABORATORY TEST REPORT fax 425.745.1737 Project Edmonds SD Edmonds Elem School Walkwa Project No: E4175 Site Address: 1215 Olympic Ave Issued on: 9-7-04 Edmonds,WA Permit # (s): 2004-0517 - E6 Client: Edmonds School District Original: Engineer: Coughlin Porter Lundeen Revised: Contractor: Flag Construction Z 0 0 M FIELD DATA (ASTM C31 and C172) =i _9 Air Temperature: 86 0 F Actual Mix Proportions: Ui --i X Weather: Clear Ingredient Weight (per cu.yd) M C 0 M Product: "�Oncrete Coarse Aggregate 1,935.0 lbs 0 --1 0 0 Supplier: Glacier Northwest Fine Aggregate 1,256.0 lbs C: --i F. Ticket Number: 56 271�' Water 240.0 lbs X M M MixDesign ID: 3210 Cement --Type 1 516.0 lbs 10--i ple Temp �(ASa ple Temp Ini'tial Storage Entrained Air I Daravair �Cl 3.0 0Z C: > Sm TM C10 (ASTIVI C231) 0 6 Temp. (ASTM C31) M cn 84 0 F NR % 0 _n �ater I C�enient R�atio7l �um p (A �ST M 54 �)J It S a m p I e (s) e d n ed Strength 0.465 50, 8-10-04 :e q- u-i r -(fc 3000 Psi@ 28 days m M 10r�_c_er�jilocation and Notes 1 cn 0 r- Elevated walkway Building C, southeast corner. A-6 to B/4 to 5. 0 M C cn 9 Cn M 0 Z -A COMPRESSION TEST RESULTS (ASTM C39, C1231, and C617 when applicable) Date Made Sample # Lab # Date Tested Age (day) Load (Ibs) Size (in) Dia (in) Surface Area Strength (psi) Failure Code X 6126 J�xl 2 r 2 8.� 8/9/2004 6=0 0 0605-FC I F8/12/2004 0 F il 0 L:��C -T-6 12' Oil E.8/9/2004 1 0065-_ffL73329 1_8/13/2004 4 -69930 2�7�O NA I---- - > Z - _/__6 __ IF 58C�[lfCtL1[C__] 8/ 04 100 16 1 126C4 7 J 73 1 _14A --I M _/6 �� 0 0 4 1 28 11 12909 -I [d. 7q �57 -61 E [J:/�/��004 �000 — 0 �� _4570 j E ch Z __3Y1 9— -1 9i64004 1' 28 1 2652 28.27 r 8/ /20 4 _�_iY.11_�_-005] F 0005 1_4�U 1_�KA�] 0 __4 6/z x 12 :4-IJEF 263i6 J 4/9/2Q64 73333 C/ 10 0 _Q65 M Remark: Inspector(s): C.Trip Edgerton Tested by: Scott J Johnson Reviewed by: rA Beckerle, P.E. Rranch Marager NOTES: Failure descriptions for samples tested with neoprene pads are not required per ASTM Std. NA = Not Applicable, S = Shear, C = Cone, cSp = Cone and Split, CSh = Cone and Shear, Col = Column FC - Field Cure NR = Not Recorded information In this report applies only to the actual samples tested and shall not be reproduced without the approval of Mayes Testing Engineers. Inc. MTE Form #150. Rev 3, 7-0 MAYESTESTING ENGINEERS, INC C r—n N r 14 REPORT ONCRETE LABORATORY TEST Project Edmonds SD Edmonds Elem School Walkwa Project No: "'"c' Site Address: 1215 CIlympic Ave R Z E C, r' _I V E Dssued-on: E mo dmonds,WA S�"EP 2 � 2004 Permit# (s): Client: Edmonds School District Epvjc� -,original: FV� Engineer: Coughlin Porter Lundeen .11�1 OF EUMONO" Revised: Contractor: Flag Construction � E4175 9-16-04 2004-0517 Everett Office 917 - 1341h Street SW Suite A-1 Everett, WA 98204 ph 425.742.9360 fax 425.745.1737 FIELD DATA (ASTM C31 and C172) Air Temperature: 83 0 F Mix Proportions: Weather: Sunny Product: Concrete Ingredient Weight (per cu.yd) Coarse Aggregate 3/4" 1,933.0 lbs Supplier: Glacier Northwest Fine Aggregate 1,269.0 lbs Ticket Number: 593614 Water 175.0 lbs MixDesign ID: 3210 Cement -Type I & 11 518.0 lbs Sample Temp. Initial Storage r Entrained Air (ASTIVI C1064) Temp. (ASTIVI C31) I (ASTIVI C23 1) 80 0 F NR % Watcr / CemcnL2� P-lu mp (ASTIVI C143) ]'[Sample(s) Rec'd 0.338 411 8-19-04 lRequired Strength (f c): 3000 Psi@ 28 days JPlacement Location and Notesi North side elevated walkway. COMPRESSION TEST RESULTS (ASTM C39, C1231, and C617 when applicable) Date Made Sample # Lab # Date Tested Age (day) Load (lbs) Size (in) Dia (in) Surface Area Strength (psi) Failure Code 8/16/2004 1 0006-FC IT E :2:8:2 3 =0 T0006-FC7 ?004 3650�:�4 X �8F4-011 E1�2�-93 2 8=9 0 8/18/2004 0006 ----][::4— 173667 F8/25/2004 1 7 2890 1 [:4�,:Q F E 40=0 -1 1 0006 173668 1-6/-1-5/2004 F-287 1 59650 EE2.�7 8/18/2004 1 04 1 28 11 �5946�(�l __1E5 5 - F-28 ::�8:66 8 Rool 6 19/15/2004 __Tx= 1 2=5 7 Remark: Inspector(s): Lonny Morrison Tested by: Tom Freeland Reviewed by: T ri imo�thy G. B P.E. Branch Manager NOTES: Failure descriptions for samples tested with neoprene pads are not required per ASTM Std. * NA = Not Applicable, S = Shear, C = Cone, CSp = Cone and Split, CSh = Cone and Shear, Col = Column FC - Field Cure NR Not Recorded Information in this report applies only to the actual samples tested and shall not be reproduced without the approval of Mayes Testing Engineers, Inc. MTE Form 050, Rev 3, 7-0 Z 0 0 M =n- C/) m ITI 0 0 0 0 C M M Z C/) o -n n m M 0 0 0 M C CJ) 9 Cn M 0 Z X > Z Cn Z 0 i 0 m CITY OF EDMONDS SPECIAL INSPECTION AND TESTING AGREEMENT The project at'CA-Ull, issued under building L �cial inspection and/or testing per UBC Chapter 17 permit fiumber 7", Tow 2::: requires spc -c'1�2. The complete list of special inspections is attached to this document. and WAC Amen me�ts 00 BEFORE A PERMIT CAN BE ISSUED: The owner and contractor and e al inspector shall sp cdiule including the complete this agreement and the attached structural test(s) and inspections sch required acknowledgments. . APPROVAL OF SPECIAL INSPECTORS: Each special inspector shall be approved by the Building official prior to performing any'duties or ins2ections. Ekh special inspector shall submit Statement of alifications to the Building Official for review. Special inspectors shall display (�uean perform' - I i ispections on site. Special inspection and testing shall meet identification wh . ing specia ir the minimum requirements of U13C Chapter 17 and the following: i , * * P Snerini In------ 1. Observe Work ce with the approved The special inspector shall observe the site work for conforman d) plans and sp�cifications and applicable workmanship provisions of the UBC. (stampe an aid to inspection. Architect or En�ineer reviewed shop drawings may be used only as . Special inspections are to be pertormed on a continuous basis --meaning that the special inspector is on site at all times observing the work requiring special inspection. Pehodic inspections, if any, must: have prior approval by the City based on a separate written plan reviewed and approved by the Building Official and the engineer or architect of record. 2. Report Non -conforming Items The special inspector shall bring nonconforming items to the immediate attention of the contractor and note all such items in the daily field report. Any item not resolved in a timely manner shall be immediate cause of the special inspector to notify the Building. Official of the plan deviation, error, change or omission. It shall also be the duty of the special inspector to promptly notify the engineer or architect. 3. Complete Daily Reports Each special inspector shall complete and sign both the special inspection record and the daily report form for each day's inspection. These records shall remain at the jobsite with the contractor for review by the City Building Inspector. 4. Furnish Weekly Reports y shall furnish the City with weekly reports of tests The special inspector or inspection agenc, and inspections. The project engineer or architect, and others as designated shall also be copied on reports. Weekly.reports must include the following: cable locations • Description of daily inspections and tests made with appli • List of all nonconforming items • Report on status of nonconforming items (resolved or unresolved8ity if not included in *Itemized changes authorized by the Architect, Engineer and nonconformance items 5.'Furnish Final Construction Report The special inspector.or inspection agenci y shall submit a final signed report to the City stating that all items requiring special inspection and testin& were fulfilled and reported. And, to the f his/her knowledge the project is in conformance with the approve.d. plans and best o ns of the NF8fications, approved change orders and the applicable workmanship provisio * Items not in conforinance or unresolved items or any discrepancies in inspection coverage, (i.e., missed inspections, periodic inspection when continuous inspections were required, etc.) shall be specifically itemized in this report. Z 0 4 0 M =i =-n M M C M 0 0 0 0 C: M M Z _Z C/) o -n n M M 0 V; 0 r- 0 M C ri) 9 U) M 0 Z 7-1 3: Z --I 3: Cn Z 0 M B. Contra91QL2KaAQ01hiUfiU 1. Notify the Special Inspector it is the duty of the contractor to notify the special inspector when work is ready for special inspection. Note, the items listed on the attached schedule ad 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. Retain Special Inspection Records The contractor is responsible to retain at the jobsite all special inspection records submitted by the special inspector. These records are to be provided- to the City building inspector upon request. C. Ci partment Responsibilities 1. Approve special inspectors or inspection agencies The building department shall approve all special inspectors and special inspection requirements. 2. Monitor special inspection and approv e weekly reports Work requiring special ins ection and the performance of special inspectors shall be monitored by the City Buf1ding Inspector. His/her approval must be obtained prior to placement ot concrete or other similar activities in addition to that of the special inspector. 3. issue Certificate of Occupancy The Building Official may issue a Certificate of Occupancy after all weekly special inspection reports including the final report have been submitted and accepted. 0 The project owner or t.he engineer or architect of record acting as the owner's agent shall fund special inspection services. E. Engineer or Architect of.R ord Responsibiliti The engineer or architect of record shall include special inspection requirements on the plans and specifications. ACKNOWLEDGEMENTS I have read and agree to comply with the terms and conditions of this agreement. 61'11A(WAI l5elloel /?;Z-l-t I , . -tel )U. SpeCial ijuakjector� �2,1'/K, / ;I- - yv- late ZV General Contractor --.at City Building Official—�A� ate, IWO el- z 0 i 0 M 7, =5 M C M 0 --10 0 C: --i K 3: M M Z g) —1 C C/) o -n n —1 3:9 M M 0 5) 0 r- 0 M C ce) 9 U) M 0 Z z C/) z 0 M 2VS- SPECIAL INSPECTION AND TESTING SCHEDULE PROJECT NAME PRON= ADDRESS REINFORCED CONCRETE, GUNITE, GROUT AND, MORTAR: r�rrvta ir-"nite Grnnt Mnrtiar Aggregate Tests Reinforcing Tests Mix Designs Reinforcing Placement Bitch Plant Inspection inspect Placing Cast Samples Pick-up Samples Compression Tests PRECAST/PRESTRESSED CONCRETE: pilpe Prvd.Tens Pre -Tens Mddine AgMgate-Tests Reinforcing Tests Tendon Tests Mix Dcsiens Reinforcing Placement Insert Placement Concrete Batching Concrete Placement Installation Insepction Cast Samples Pick-up Samples )rcssion Tests MASONRY- - Special Inspection Stresses Used — Preliminary Acceptance Tests (Masonry Units. Wall Prisms) — Subsequent Tests (Mortar. Grout, Field Wall Prisms) — Placement inspection of Units ADDITIONAL INSTRUCTIONS OR OTHER TESTS AND INSPECTIONS: BUILDINGPERMUN0. TE=Nc�riNsrEcn0N AGENCY or *ECIAL INspEcrOR STRUCTURAL STEELIWELDING: — Sample and Test (list specific members below) — Shop Material Identification — Welding Inspection 0 Shop 0 Field — Ultrasonic Inspection 0 Shop 0 Field — High -strength Bolting Inspection 0 Shop 0 Field 0 A325 0 N 0 X 0 F 0 A490 Metal Deck Welding Inspection Reinforcing Steel Welding Inspection Metal Stud Welding Inspection Concrete Insert Welding Inspection FIREPROOFING: - Placement Inspection — Density Tests — Thickness Tests — Inspect Batching 0 INSULATING CONCRETE: - Sample and Test — Placement Inspection — Unit Weights FILL MATERIAL: — Acceptance Tests — Placement Inspection — Field Density STRUCTURAL WOOD: - Shear Wall Nailing Inspection — Inspection of Glu-Jam Fab. — inspection of Truss Joist Fab. — Sample and Test Components Form completed by: Title: Telcphone No.: Date: z 0 i 0 M --i -n Cl) 0 M C M 0 0 0 0 C: M M Z jc) —i 0 _n n M M 0 0 0 M C C/) 9 (n Q 0 Z z CD z 0 1 0 M FINAL PROJECT APPROVAL FORM TO: DATE: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: FIRE DEPARTMENT DATE 'r SIGN ENGINEERING DIVISION DATE PLEASE SIGN PLANNING DIVISION DATE PLEASC SIGN PROJECT- "S e SITE ADDRESS L( PERMIT #Jn0Y—_0��ADB#____LDATE INSPECTED DESCRIPTION OF WORK TO BE INSPECTED ::1 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 PERFORAIANCE 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 FAILED FINAL INSPECTION - OUTSTANDING ISSUES 0 Copy of CORRECTION NOTICE given to owner/contractor by inpector I . 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Signature 1:tcn11):b1dg:f6rnis:ocaprv1 3/25/04 z 0 M --i -n 0 M C M 0 0 0 0 C: --I ?. X M M Z 01 C 0 71 n M M 0 0 0 M C: cl) 9 U) M 0 Z r z U) z 0 i 0 M RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footi......... I ............ Wall.......................... Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground ............. Rough -in ................... Commercial Final ...... HEATING: GasTest .................... Gas Piping ................. Equipment ................. Commercial Final ....... EXTERIOR SHEATHING NAILING.......................... FRAMING........................ FIRST FLOOR FRAMING... INSULATION ................... Floor Insulation ......... Wall Insulation ........... ulation ....... Ceiling Ins SHEETROCK NAILING ... SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. z 0 1 0 M --i -n W M C M 0 0 C M M z C _z 0 _n n 3:9 MIT! 050) 0 r, I I 0 M C 0) 9 Cn M 0 Z z Cn z 0 i 0 M