20040657.pdf0
DATE FICCEIVFD
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS
MAILING ADDRESS
CITY ZIP TEL -PHONE
VCM40I"vb5 I WA-.
NAME
ADDRESS
NAME
.1"t 0. o. P
ADDRESS
051,52
CITY
ZIP
ZIP
4 zzlff fz_'r-r'. � f I
STATE LICENSE NUMBER,
PROPERTY TAX ACCOUNT PARCEL NO.
Oct)
-Y&?-q-7%1
� �78 L 0
TELEPHONE
EXPIRATION DATE
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NEW
RESIDENTIAL
ADDITION
COMMERCIAL
REMODEL
MULTIFAMILY
E:]
REPAIR
GRADING CYDS
DEMOLISH
TANK
GARAGE
rARPORT
RETAININGWALL
ROCKERY
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN
.1
ujl NUMBER NUMBER OF
C' OF DWELLING
M
0 STORIES UNITS
DESCRIBE WORK TO BE DONE
� PLUNiBING / MECH
COMPLIANCE OR
CHANGE OF USE
SIGN
FENCE
( x Fr)
OTHER
FIRE SPRINKLER
FIRE ALARM
PERMIT EXPIRES
U 1-3 F
/ON�
PERMIT
N U M B ER
job
ADDRESS,,,
IUITE/A7#
4
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PI AT NAMEISUBDIVISION NO
LOT NO.
LID NO�
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCIP Approved
RW Poratit Required
0
0
street use Frerrit noq'd
[3
EXISTING - PROPOSED
inspection Required
Q
Sidewalk Requited
[3
REQUIRED DEDICATION-
FT
Uncle(ground
Wiring inquired
13
METER SIZE
LINE SIZE
NO. OF FIXTURES
I
PRV REQUIRED
I
YES 1:1 NO
13
REMARKS
OWNEWCONTRACTOR RESPONSIBLE FOR EROSION CONTROLYDRAINAGE
NG REVIEWED BY
FIRE REVIEWED BY
VARIANCE OR CU SHORE 7INE OR AD13#
BAT E
DATE
Ll
INSPECTION
137ND
REO'D
POSTED
1
OYES
ONO
$
SEPA REVIEW SIGN AREA HEIGHT
COMPLETE I EXEMPT ALLOWED , PROPOSED ALLOWED , PROPOSED
EXP
LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT L/R SIDE REAR
PARKING
REO'D I PROVIDED
ft14TEV1. mwl
LOT AREA I PLANNING REVIEWED BY DATE
CHECKED BY jTY.P,E.0,F,,CO3NSTRUCTION
CRITICAL
AREAS SPECIAL INSPECTION JAREA
NUMBE R Aj REQUIRED
YES
CODE OCCUPANT
GROUPr/
OCCUPANT
LOAD
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REMARKS 0
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PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REQ'D F3
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V rION
$ 41, - /' � �0
Description FEE Description FEE
Plan Check -71 State Surcharge
HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge
ECK Pi!Q; VESTED DATE Plumbing Base Fee
�2
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
13E DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: 180 DAYS
uj
PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
U3 ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit
U) 4APPLICAN1.
W IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
_j
EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NAI URE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT HE
DEEMED TO MODIFN� WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total Amit. Due
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.*
Recording Fee Receipt
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 APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application is not a perinit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy; and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided,
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. OFFICIALS SIGNATURE DATE
SIGNATURE.. on DATE SIGNED (425)
.I /f'. �. � 6�8 'u/
IL'614L, 4 ?L)- 771-0220 qD Air
A E L DATE
ATTENTION EXT 1333
71
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW.INSKEC"TIR"
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
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1994 Washington State Nonresidential Energy Code Compliance Form
Summary LTG -SUM
wh1nrdnn Rtata NonrOslderrdal Eneray Code Complianoe Foffne SemnMition - Jurm 1M
_�_or
MMI
UP "04 jV[Q=&V
Bulidin Depad*nt Use
9
re M
rift 0 1 7/1 MR
Eren, 157RETUT-7
�Tft
[Proi ect Description I Ll New Building U, Addition __ 'A Alteration -1
pliance Option L3 Prescdptive )aughtlng Power Allowance D Systems Analysis
Fcom I (See Quallfication Checklist (over). Indicate Prescriptive & LPA spaces clearly on plans.)
Alteration Exceptions U No changes are Wng made to the lighting
(dvmk appropriate box) U Less than 6(r/. of the fixtures are new, and Installed lighting wattage Is not being Increased
11 A ir . '164-6% Wnffn a (Tinteriorl
maximum A
Location
(floor/room no.)
uvvv. t n 0
% Occupancy Description
Ailowed
Watts per fe
Area In fe
Al x Am
P t
From Table 15-1 (over) - document all exceptions taken from footnotes Total Allowed Wattsi
Proposed Lighting Wattage (Interior) (May not exceed Total Allowed Watts for Interior)
Number of
Location
Fixtures
(floor/room no.)
Fixture Description
ROWO '32v -rep
- d
Watts/
Fixture
*01
Watts
Proposed
9__ :10 9P
to IV 4�_Mlw &Q*A6_'j
Total Proposed Watts may not exceed Total Allowed Watts for Interior Total Proposed Watts
Maximum Allowed
Lighting Wattage (Exterior)
Location
Description
Allowed Watts
per fe or per If
Area in fe
(or If for pe meter)
Allowed Watts
x fe (or x If)_
0.2 WIff
-
0.2 We
Covered Parking
open Parking
0.2
0.25 W/fe
7.5 W/If
oor Areas
Bldg. (by facade)
Idg. (by pedm)_
Note: for building exterior, choose either the facade area or the perimeter method, but not both) Total Allowed Watts
Proposed Li hting Wattage (Exterior) (May not exceed Total Allowed Watts for Exterior)
Number of Watts/
Location Fixture Description Fixtures Fixture
Watts
proposed
Total Proposed Watts may not exceed Total Allowed Watts for Exterior Total Proposed Watts
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1994
1994 WashlngtO6 State Nonresidenfial Ene'rgy Code ComPliance Form
1111111r'!1 1W =.I
Sts" Nw;;;�WOW EMW code CompRarce Fonne
LTG -SUM
Table 15-1 Unit Lighting Power Allowance (LPA) for Interior'Lighting LPA!
ILPA! (WM
__MT� U8W re stations* 1.2
PaIntl , welding, machima V 2.3 Att atriums 1
Barber shops, beauty shops 2 Assent oaces9 auditoriums rmnaslag thesilem 1
Hotel uettconfenance/whibition halP"' 2 ly sl process is I
LaDorewnm 2 RestaurantsfbM6 I
A) ft repair NyVan; '1.5 A10 I
Caleterias test fOOd establishments' 1.5 Ftetall B'Q il banking 1.5
1.5 a!L=_"_= 0.8
Factories workshops, handling areas 1.5 Locker andlOr shower tacilitles 0.5
Gas auto Ir shoW 1.5 Warehouses'. Dra arMS 0.4
Instttu*m 1.5 AIrcraft storaqe h rs - a" secom 15M
Ubrarless 1.5 Parking ga
Nursing homes
W stores (pallet rack sheM 1.5 Plans Submmw for common Aram Oni
hiall concourses 1.4 CCrnmon area, Corrkj=. k)bbi8S 0 mall concourse 0.8
schools buildi Is, school assroornS, care centers 1.35 9t Itfies and washroom 0.8
1.3 ToN
Lai
buildings, oticatedminis"mys areas In facilities of
1.2
OftV use t
,1M (including but not limited to Schools-
dOM- musewis, banks, church0a 7
hosp
r ablS 15-1
In cases it, which a u se i s n ot mentioned 'Pcci fically, the Un't P~r A Ub-11111 sball,be determined by the building official. This
determination shall be based upon the Most comparable use specified in the table. See Section 151.2 for W=pt areas.
2. Ile waus Per square foot may be increased. by two per= It per foot of ceiling height above twenty feet, unless specifically directed
otherwise by subsequent footnotes. per fbot of ceiling height above twelve feet-
3. Watts Per square foot of room may be increased by two percent
4. For all Other spaces, such as seating and common arms, use the Unitugh, Powor AUowance for assembly
5. Watts per square foot of room may be increased by two percent per foot of ceiling height above nine feeL
6. Includes pump area under canopy. for only a portion of a floor, a Unit Lighting Power Allowance of 1.35 may be used for
7. In cages in which a lighting Plan is submitted are foot shall be used fbr the common areas, which may include elevator spacc, lobby area
usable office floor area and 0.80 watts per squ
and rest rooms. COmMon areas, as herein defined do not include mall concourses-
B. For the fire engine room, the Unit Lighting power Allowance is 1.0 watts per square foot. cc or th cou area
9. For indoor sport tournament courts with adjacent spectator seating, the Unit Lighting Power Allowan f e rt is 2.6 watts per
square foot. standing display, building showcase illumination end display window illumination installed
10. For both Retail A and Retafl B, light for free -
within two feet of the window are exempt. Ceiling mounted adjustable tungsten halogen and HD
Retail A allows a Unit Lighting Power Allowance of 1.0 watts per square foot.
merchandise display illuminaries are exempt. including all ceiling mounted merchandise display
Retail B allows a Unit Lighting Power Allowance Of 1-5 watts per square foot,
luminaries. gbt, is submitted, the square footage for a warehouse may be defined, for
11. provided that a floor plan, indicating rack location and bei f area (access de only)
computing the interior Unit Ugbdng Power Allowance, as the floor area not covered by racks plus the vertical ace si
of the racks. The height allowance defined in footnote 2 applies only to the floor area not covered by racks.
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_V E D
2004 FINAL PROJECT APPROVAL FORM.
1)V_,,jF,LoPM01_ 'SE1_1\J'CES CTR' TO:
CiTy OF EDMONDS
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: —FIRE DEPARTMENT DATE
PLEASE SIGN
ENGINEERING DIVISION DATE z
0
PLEASESIGN --I
0
PLANNING DIVISION DATE M
PLEASESIGN
PROJECT, P_ic_VG�
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SITE ADDRESS—, 0
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PERMIT # Co-S7 ADB# DATE INSPECTED 3: M
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DESCRIPTION OF WORK TO BE INSPECTED f2& =407 0 >
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
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:fon-ns:ocaprv1 3/25/04
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
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Retaining Wall ...........
-4
0
Slab Insulation ..........
1711
PLUMBING:
Underground .............
M
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Rough -In ...................
0
0
0
Commercial Final ......
C
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HEATING:
M Z
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Gas Test ....................
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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
OCCUPANCY ..................
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