20040723.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
�0)R i "FIAC 7 IZZA C p�5�+�
MAILING ADDRESS
13� 4� DL �M(-)�C U�t�.�L� �oJI
CITY
NAME
ADDRESS
CITY
ZIP TELEPHONE
-�71 y-7,9
ZIP
TELEPHONE
0`q�
USE
ZONE
JOB
ADDRESS
PLAT NAME/SUBDIVISION NO.
PERMIT EXPIRES
PERMIT 7 '
NUMBER ��, �J-I �o �-=
NO.
L
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING PROPOSED
REQUIRED DEDICATION Fr
METER SIZE I LINE SIZE I NO. OF FIXTURES
SUITEIAPT#
LID N0.
LID FEE $
TESCP Approved
RW Permit Required
Strom Use Permit Rngd
Inspection Required
Sidewalk Required
Underground
Wiring required
PRV REQUIRED
YES ❑ NO ❑
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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NAME GBI.#
��'•%Arl_ i (.LLIl%7 �1�` .S C 2'( 1 ENGINEERING REVIEWED BY DATE
p ADDRESS
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CITY ZIP TELEPHONE LL
0 +TjL- t eery Yx; - 335? elf S
EXPIRATION DATE BY VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND
POSTED
STATE LICENSE NUMBER Qd / _ � 1 �1
1 SwF 1 1 J �lT lJ� V ❑YES NO Is
�1Y SEPA REVIEW SIGN AREA HEIGHT
COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
jPROPERTY TAX AC 11NT PARCEL N0.EXP
O S li�
j'� �PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
❑ NEW S +� ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR O
COMPLIANCE OR
❑ ADDITION �I COMMERCIAL ❑ CHANGE OF USE z
/~( PARKING LOT AREA PLANNING REVIEWED BY DATE IL
❑ REMODEL SIGN REQ'D PROVIDED
❑ REPAIR ❑ GRADING CYDS ❑ HENCE X FT)REMARKS
❑ DEMOLISH ❑ TANK ❑ OTHER
GARAGE RETAINING WALL
z ❑ CARPORT ❑ ROCKERY ❑ FIRE
SPRINKLER
RE ALARM
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(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:rL C OCCUPANT
aZ CHECKED BY TYP f GROUP
U
oNUMBER NUMBER OF CRITICAL
OF DWELLING 1 AREAS I SPECIAL INSPECTION AREA OCCUPANT
UNITS NUMBER REQUIRED ❑ YES O STORIES LOAD
DESCRIBE WORK TO BE DONE
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REMARKS z
PROGRESS INSPECTIONS PER UBC 108/ IBC109 / IRC109 FINALINSPECTION REO'D
VALUATION
Description FEE Description FEE
Plan Check State Surcharge
HEAT SOURCE GLAZING % LOT SLOPE % City Surcharge
-'
Building Permit Y 9e
PLAN CHECK NO: VESTED DATE Plumbing Base Fee
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
!= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
-t SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: 180 DAYS
uj
a PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
rn 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
Q ALI. CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECT LY
= FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscape Insp. Total Amt. Due
o DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
O NOR LIMIT IN ANY WAY THE. CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION "
= Recording Fee Receipt # 211
I HEREBY ACKNOWLEDGE MAT I HAVE HEAD THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT 1 AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC CALL This application is not a t: 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 COMPENSATI RANCE AND RCW 78.27. OF FI S .GNAT HE D TE
/ SI URE (OWN AGENT) DATE SIGNED (425)
-Y' ._ rJ Z', ^ t' y 771 �02120 RELEASED BY DnT4t
ATTENTION EXT 1333
IT IS UNLAWFULTO USE OR OCCUPYABUILDING OR STRUCTURE UNTILAFINAL
INSPECTION HAS BEEN MADE AND APPROVALOR A CERTIFICATE OF OCCU- ORIGINAL - FILE YELLOW - INSPECTOR
PANCY HAS BEEN GRANTED. UBC109 / IBC110 / IRC110. PINK • OWNEn GOLD ASSESSOR
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
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Grease Trap Sizing Worksheet
Facility Name: Porto t i ►'�O Pi z �� Fr�.f to
Addresse /3 06 n Qlidrni c. View or, 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
Fixture
Capacity
Drainage Load
Flow
Rate for
Inches
in Gallons
(75% ol'Total
a 2-Minute
(L x W x D x no.
of sinks)
(Cu. In. _ 231)
Capacity)
Drain Period
#1
x /
x) 'L.x 2 _
go72c.i.
—
231 =
�1 gal,
x .75 = 30
gal.
- 2 =
/5 g m
.:.1
#2
x
x x =
c.i.
-
231 =
gal.
x .75 _
dal.
- 2 =
g m
#3
x
x x =
c.i.
-
231 =
gal,
x .75 =
gal.
- 2 =
gpm
#4
x
x X =
Colo
-
231 =
000_al.
x .75 =
gal.
— 2 =
gpm.
Grease
Trap
#1- Total
drainage flows
from
maxinium
of 4 fixtures
gpm
#1
x
x x _
Cole
—
23 t =
gal.
x .75 =
gal.
- 2 =
gpM
#2
x
x X =
Colo
-
231 =
000al,
x .75 =
gal.
— 2 =
2111
#3
x
x x =
Clio
-
231 _
al.
x .75 =
al.
— 2 =
in
#4
x
x x =
coil
-
231 =
gal.
x .75 =
gal.
— 2 =
ED1711
Grease Trap #2 —Total
drainage flows
from
maximum
of 4 fixtures
gPm
MINIMUM
SIZE OF GREASE TRAP(S) REQUIRED
gpm
Number of Fixtures Connected to a Grease Trap 1 2 3 4
Grease Trap Size (in m) 20 25 35 50
Upsize for factors such as high volume dishwashing, high oil/grease content on menu, etc.
----------------------------------------(For City use only below this line) ----------------------------------------------
Remarks: _ T r'rgU, j size i2la - uO;11 Flot in iAe.
Size Approved 20 gpm Approved by: Date:
I'retrcutn it'1'cchnici:ui
FIN
OVAL FO
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
PRETR�.ATN1E
FROM: �✓ ''m- �i��
PROJECT P
SITE ADDRESS
TO:
DATE:
ATE '/ - IL 0
ENGINEERING DIVISION DATE
PLEASE SIGN
PLEASE SIGN
to
/ 306 01
G DIVISION DATE
PERMIT # 220 O 4 - D 7 2.3 ADB# DATE INSPECTED �1- / ~ a
DESCRIPTION OF WORK TO BE INSPECTED
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
❑ Copy of CONDITIONS given to owner/contractor by inspector
1.
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
❑ Copy of CORRECTION NOTICE given to owner/contractor by inpector
1.
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1: to mp:bldg: forms: ocaprv13/25/04
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall ..........................
Pier/Porch Z
O
—I
Retaining Wall ........... n
m
Slab Insulation ..........
PLUMBING:
c
2
Underground m
m 0
Rough -In ................... O
OC
Commercial Final ...... —I
HEATING: m Z
poloo-I
....................
CZ
Gas Test
r --I
Gas Piping _
U)
Equipment
Commercial Final ....... f=tl m
EXTERIOR SHEATHING 0 6
NAILING .......................... 0 r
C
rn
FRAMING ........................ U)
m
Z�
FIRST FLOOR FRAMING... -1 ITl
INSULATION ................... X
2
Floor Insulation ......... Y
Z
Wall Insulation
Ceiling Insulation ....... Z
O
SHEETROCK NAILING ..l shonall
n
SPECIAL INSPECTION ... m
MISCELLANEOUS ..........--s
FINAL APPROVALr9Q&L / ` (/!i
�Y .................. 11 ,r I
fir' ,