20040836.pdf3
DATE RECEIVED /0
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER AME/NAME OF BUSINESS
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MAILING ADDRESS
CITY ZIP TELEPHONE
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NAME
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STATE LICENSE NUMBER
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PLAT NAMEISUBDIVISION NO. LOT NO LID NO.
LID FEE $
TESCP Approvorl
PUBLIC RIGITT OF WAY PER OFFICIAL STREET MAP HW P.11mit Floquiled
street usn Ponnit Roqd
EXISTING Inspriction Requirod
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REMARKS IF, tOPERTY Ll 14 8
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OWNER , !CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
VATER M=.R TO BE REMOVED OR
NEW
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RESIDENTIAL
PLUMBING / MECH
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CHANGE OF USE
REMODEL
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SIGN
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FENCE
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>��DEMOLISH
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RETAINING WALL
ROCKERY
FIRE SPRINKLER
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NUMBER
NUMBER OF
CRITICAL nwuff
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GLAZING %
LOT SLOPE %
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
SEPARATE PERMISSION.
PERMIT APPLICATION: 160 DAYS
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 100 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
"APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOT D HARMi ESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALI. CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF 1111S PERMIT SHALL NOT HE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY Cl IY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY'S A131LIlY TO ENFORCE ANY ORDINANCE PROVISION '
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. 111AT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER I AGREE TO COMPLY WITI I CITY AND STATE LAWS REGULATING CONSTRUC
TION AND IN DOING 1HE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VItOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18 27.
SIGNI�TUR (OWNE , R AG _N�j DAI E SIGNED
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ENGINEERJP PlUfYR11IST ON BACK OF JOB'CA
FOR INSPECTION REQUIREMENTS
FIRE REVIEWED BY DATE
VARIANCE OR Cu SHORELIN_� OR ADBN INSPECTION BOND
REO'D POSTED
I E1YES_ Q'NO 1$
SEPA REVIEW SIGN AREA HEIGHT
COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
EXP I 1 0 1
LOT COVERAGE REQUIRED SETBACKS (F-T) PROPOSED SETBACKS (FT)
ALLOWED PROPOSED FRONT SIDE REAR FRONT L/R SIDE REAR
PARKING LOT AREA PLANNING REVIEWED BY DATE
REO'D I PROVIDED
REMARKS
ftvh bwhey,� 17s,
CHECKED BY I TYPE.JCE-CONSTRUCTION q OCCUPA"
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REMARKS )N RECI'D Iii
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTR
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
,)5--City Surcharge 1,5
Base Fee
CALL
FOR INSPECTION
(425)
771-nggn
Plan Chk. Deposit
Receipt #
Total Amt. Due o
Receipt # 0 & (0
APPLICATION APPROVAL
Tins application is not a permit until signed by the
Building official or tusItief I)eputy. and Fees are paid, and
receipt is acknowledged in space provided
FridIALS SIGNAIURF DATE
I t �, L I , 0
ATTENTION E)ff 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL E
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
E
ORIGINAL- - FILE YELLOW - INSPECTOR
PINK - OWNER GOLD - ASSESSOR
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05/01/2004 15:37 425G700470
r%gt:IIt;y %.,Use INO. I
20OLL01784
Agency lise Only
BILL AND M,II BICKEL _
P�JGET SOUND CLEAN ALR AGENCY
I 10 1, Inion Sti-cet, Suite 500
sedt�icj WA 98101-2038
www,pscicanair.org
NOTICE OF INTENT
PAGE 02
Date Received
I AY 3 2004
Ageno, U-se Only
A. Proiect Tyne; 1. C3 Friable Asbestos R- enloval 2. Q, Friable A5bKsl05-ReMQvR1 I Qe`nQll1lqn---3-LU De"1011lon Only
B. 71- 7W-Z-?
Property Owner: -T-�)OhAS - Fzip-.1719�61
Mailing Addrcss: five 50 -Ci State
ftr4SR PRINT CLI;My, NO$ WILL BE UR.R45TU WAILIM-.
Ci rcs
is WILL UNN451-u WAMIM
7/
C. Asbestos
Contr2ctor-, 0wncr/CEO: Contractor
Mndinv Address-. Phone: Job No.:
a
City: State; ZiE: Fax:
City;
Site z i
Address:
site 71-7FZ2�
Manager: Local Phone.
—E—.IUMb�estosSurvey or No. of Date of A Was Friable Asbestos Identified? 0yes WNo
S�c '2 No ffi icd? QtYes UNO
a t'l presumed Strucakre. Stu -Vey: Sr 2�aoo Was Nonfriable Asbestos Identif
Ila it ( co
DL
Certification Attach (I copy of III e stave ' y when friable asbestos
,t_
AHERj% Building Ehas not been identified.
Insr)ector: IdtrL i�� Exp. Date:
7, n 7HERA Sumay is required �bejbreall demolition P,
F. Demolition Start Majt),,3�
Infornution: I Datc.
insor, demolition contraCror's
Demolitioll
Contractor: UV t\-e-r
G. Friable Asbestos
Project Information: Start Datc:
1. LJ Training Fire (List Fire Dept.)
rl r NO, Of
e
Structures, Ordered Dcmolition (attach copy of Order!
ing address on back Will nonfriable asbestos be left in place dwing demo? Ll Yes "U No
asbesto'
I If yC!J
f yc!,, list type a=nd qty.
, �ri
;e
Work Days: M T W Th F Sa Su
Hour_.
D:tc- S.
tion Date: Hours:
W Wlll at
ill all friable asbestos Cl Yes
Total Qty- to be Removed: Linear Ft. I S uare Ft. materials be temoved?
Paints U Plaster Ll Textur7d
U No
Coatings
13
Bo El
i—leffumace insulation
Duct In u ation Pipe Insulation U Firproofing -------------
U Cc -nent Board
Ccmen Pi e Friable Flooring Friable Roofing Materi al Other:
--
-flca
NQtiflcation Peripidi
I
Project
Demolition
Asbestos/Demolition Project C;itegories:
Fee
e
Surchare
Single -Family Residence (owner -occupied)- NotIct
A. Prior Notice
A 0 '1,
A $25
A, C] Asbestos Removal Project Only yse
B. � P. Demolition Project (with or without asbestos removal project) 1�0 Days$
1. �§.
L
� demoli t wait 10 da sl
*(Asbestos removal can begin upon notification rion mus
has been or will be using the residence as their domicile, the above boxes
Note: ff(he singlefiimily residence is owned by onefamtky who
Of rite categories listed below must be
used. .4 singlej4mil.v
IA or IB may be checked. If this is not am Owner -occupied residence, one
-use buildin .
-tv multi-familv units, or any mixed
7 residence does not include rental propei...., le Asbestos Ord
—All remov it or Nonfriab
10 Days
1201
2. a Other Demolitions with no Asbestos
!X
Asbestos Demo
Friable Asbestos Prolects
(other than Single Family Residence):
V
Prior Notirr 10 Days
$100
S100
sloo
3,11.1,
2: 10 - 2-59 linear fc et and/or �: 48 - 159 square feet of asbestos
10 Days
$200
$100
li�
U MO - 999 linear feet and/or 160 - 4,999 square feet of asbestos
_JS200
10 Days
50
S250
1;
>1 1100 linear feet and/or >5.000 sQuare feet of asbestos
�,%Ice
Proiect Fcc
Emericricy Asbcstos PTOJeCl or
6.
amily Residences 31-e eXCMPt FrOl" e
Emergency Demolition Proicci
Ecncy fee� however. property owneri MU
Mlor NotiCc
%%nttcl emerg"t—rcque5t)
J pplcmcnuil data is, to the bcst of my k-nowIcdSc, accurate & complete.
icerill') at th formAtion contained in this notit su
3-P*
Date
Signature Re e, � - I
puget Sound Clean Air Agency Form No 66-160 (Revised 1;04) TS
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E A-T
ASBESTO-TEST9 INC.
"LEMTED" ASBESTOS SURVEY
1031 Grandview St., Edmonds, WA 98020
Page I of 5
IN#240447
May 1, 2004
Tom & Sue Nicholson
920 8'h Ave. S
Edmonds, WA 98020
Ph: 425-771-7873 fax: 425-580-8324
On April 29, 2004, Asbesto-Test personnel conducted an Asbestos survey (per
U.S.E.P.AJA.H.E.I;LA. guidelines as designated and specified by Puget Sound Clean Air
Agency and Washington State) of the north addition area only o he house & the "hobby
shop" structure behind the house 6� 1031 Grandview St., Edmonds, Snohondsh County,
WashjWfon 98020. This survey purpose is to identify any Asbestos Containing Materials that
may be present and will require professional removalprior to detnolition or renovation.
NA R RA TI VE OF FINDINGS
BASIC CONSTRUCTION: The north addition of the house is one story wood frame on a
concrete basement. The exterior siding is wood. The wood siding vapor barrier was sampled.
The composition roofing was also sampled.
INTERIOR CONSTRUCTION, FINISHES, AND FLOORINGS: The interior is drywall
and wood. The drywall/taping materials were sampled. Tile flooring materials with relating
mastics and backings were sampled per each located homogenous area. The laminant mastic was
sampled from the kitchen area. Most of the floors throughout are wood.
INSULATION: The insulation was sampled.
CONTINUETO PAGE 2
1429 Ave. 1). 1IN113087,Snotiontish, WA 98290 ph:206-914-5500 fax:360-5(0-2469 page: 206-540-2401
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Page 2 of 5
IN#240447
May 1, 2004
Asbesto-Test, Inc. (206) 914-5500
north addition area only of lite house & lite "hobby shop" structure behind the house 6—b 1031
Grandview St., Edmonds, Snohomiyh County, Washinpoton 98020
ELECTRICAL SYSTEM: The electrical wiring insulation is not of the kind to be ACM and
was not sampled. Any suspect electrical wiring insulation or any suspect TSI (Thermal System
Insulation) found in, around, or behind any locatedfuse or breaker boxes should be considered
to be ACM (Asbestos Containing Alaterial), unless determined otherwise by laboratory analysis.
HEATING AND VENTILATION SYSTEM: Fleating throughout is baseboard/wall electric.
There was no visible suspect ACM located associated with the electric heating units. There was no
visible suspect ACM located associated with any of the electric heating units. Note: 11 Was not
possible to dismantle the electric heating units to locate andlor evaluate any additional
suspect ACM which may be concealed, inside the units, or associated in hidden areas. It
is our opinion anyfurther handling of the heating unit's should be coordinated by the
project manager andlor abatement contractor. If any additional relating suspect
materials are located prior to andlor during any demolition or renovation, any and all
additional related suspect materials should be considered to be ACM (Asbestos
Containing Material), unless determined to be otherwise by laboratory analysis.
Misc.: None.
ADDITIONAL STRUCTURES ON SITE INCLUDED IN SURVEY: There is a work
shop behind the house. The shop is wood fTame with a metal and composition roof. The structure
is on a concrete slab. The only heating source located in the shop is a wood stove. The tile and
mastic flooring materials were sampled from the entry way and restroom areas.
# of structures included in survey: partial area of one house & shop structure in back
Requested by: Tom Nicholson
Os�ector, certified A.H.E.R.A.
accred.#CLAY 5327 (Expires 8/12/04)
A-T
conflnue to page 3
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Page 3 of 5
IN#240447
May 1, 2004
Asbc,slo-Tevl, Inc. (206) 914-5500
north addition area only of the house & the "Isobhy shop" structure behind the house (a) 1031
Grandview St., Edmonds, Snohomish County, Wavhinglon 98020
Any and all materials identified as ACM or PACM in this report (and/or additional materials
associated with the structure that may be discovered and later identified as ACM or PACM), must
be professionally abated prior to demolition. ASSESSMENT AND QUANTIFICATION OF ACM
FOR ABATEMENT PURPOSES AND/OR PRICING FOR REMOVAL SHOULD BE
DETERMINED BY ON SITE EVALUATION, AS LISTED QUANTITIES ARE NOT
GUARANTEED AND ARE AN APPROXIMATION ONLY.
,SAMPLES 1-3AREASBESTOS CONTAINING MATERIAV, I the mastic aV listed in sample 1. 1
ANALVSIS ID ASBESTOS//TVPEHQUANTITV OTHER MATERIAL
1.0) FLOOR TILE yes H chrysotile // 2-5% non -fibrous materials
house kitchen & little pieces in laundry corner of the bathroom
color: tan rock -TILE IS NON -FRIABLE ACM
APPROX. 35 SQ. IiT. ON WOOD
1.1) MASTIC NAD adhesive, cellulose
2.0) FLOOR TILE yes H chrysotile H 2-5% non -fibrous materials
hobby shop restroom-color: tan ACM
2.1) BLACK MASTIC yes H chrysotile H 2-5% adhesive, cellulose
MASTIC AND TILE IS NON -FRIABLE ACM
APPROX. 30 SQ. 17117. ON CONCRETE
3.0) FLOOR TILE yes // chrysotile 2-5% non -fibrous materials
hobby shop entry hall in front of restroom ACM
color: bluish green spec
3.1) BLACK MASTIC yes H chrysotile 2-5% adhesive, cellulose
MASTIC AND TILE IS NON -FRIABLE ACM
APPROX. 30 SQ. FF. ON CONCRETE
THERE WAS NO ASBESTOS DETECTED IN ANY OF T14E REMAINING SAMPLES
4.0) drywall
house
NAD
4.1) drywall taping compounds NAD
SAMPLED PER AFIERA PROTOCOL
4.2) surface paint (homogenous throughout) NAD
continue lo page 4
non -fibrous materials
cellulose, fiberglass,
paint, (Upsum)
non -fibrous materials,
cellulose, fiberglass
paint, cellulose
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Page 4 of 5
May 1, 2004
IN#240447
Asbesto-Test, Inc. (206) 914-5500
north addition area only of lite house & the "hobby shop"
structure behind lite house k) H )31
Grandview St., Edmonds, Snohomish County, Washinghon 98020
ANALYSIS ID ASBESTOS/rfYPE//QUANTITY OTHER MATERIA
5.0) drywall NAD
non -fibrous materials
z
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bobby shop
cellulose, fiberglass,
paint, (upsum)
5.1) drywall taping compounds NAD
non -fibrous materials,
SAMPLED PER AHERA PROTOCOL
cellulose, fiberglass
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5.2) surface paint (homogenous throughout) NAD
paint, cellulose
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6.0) laminant mastic NAD
adhesive, cellulose
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house ldtchen countertop
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7.0) tile flooring NAD
non -fibrous materials
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house bathroom -color: brown & tan design
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7.1) mastic NAD
adhesive
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8.0) insulation NAD
fiberglass, cellulose
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cellulose, tar, fiberglass,
= 9 b
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& underlying materials -house
non -fibrous materials
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cellulose, tar, fiberglass,
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non -fibrous materials
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...................................... . .....
Grandview St.
.........................
H=NORTH END OF HOUSE INCLUDED IN SURVEY, IJS=IIOBBY SHOP
A-T
continue to page 5
Page 5 of 5
IN#240447
4
May 1, 2004
Asbesto-Test, Inc. (206) 914-5500
__t.. ls�asjvdv .9 ilip "hnhhip vhnn"
Grandview St., Edmonds, Snohomish County, Washington 98020
Some sample analyses listed may be a representative analysis of individual and separate samplings and analysis of homogenous
materials, as prescribed ky A.H.E.R.A. protocol.
Samples taken arc, listed ivith their corresponding analyses. trasbestos is detected, those samples containing asbestos are listedfirst
and noted ivith the initials "A CAI ".
if during demolition or renovation, atky additional hidden or covered suspect materials similar to those identified in the survey are
located [may include but not limited to: sheet vinylflooring, tileflooring, wall or ceiling texturings or paints, concrete siding or
skirting, cement pipes, cement wallboard. electrical cloth, electrical Wring insulation, thermal paper, wallboard, joint compounds,
vinyl is -all coverings. spackling compounds, or any other suspect TSI (Thertnal System Insulation) 1, they should be treated as Asbestos
Containing Afaterials unless determined to be non -asbestos by laboratoiy ana�ysis.
Note: Asbesto-Test, Inc. does not guarantee approximations of quantities of ACM, which may be listed with the analyses. It is
therefore recommended professional abatement price andlor disposal quotes be obtained by inquiring as to fees per area of
specific ACM material (i.e. square or linear foot, etc.), or by on site assessment.
Any and all materials identified as ACM in ifts report must be abutedprior to ACM dWarbance, renovation, or demolitiom All
materials Idendfled as ACAf must be professionally abated by a licensed asbestos abatement contractor prior to any.diviarbance.
Analytical test method: USEPA 600/R93/116** (PI,M); WAC 296-62-07753 App. J
Key. ACM signifies "Asbestos Containing Material"
PACM signifles"Presumed Ask-stosContaining Material"
CAB signifies "Concrete Asbestos Board"
< signifies "less than"
TSI signifies "Thermal System Insulation"
IIVAC signifies Aleating Ventilating Air -Conditioning"
NAD signifieq "No Asbestos I)etcctcd"
"One percent is the USEPA regulatory limit for asbestos in bulk saniplLs.
PLM has been known to miss asbestos in small percentages orsouic samples, which contain asbestos, thus negative PLM results cannot be
guaranteed. Floor tiles and Nvipes should ty. tested with SFM orTFM, to insure analytical accuracy when reported in small percentages.
Asbesto4cst, ISV,��sponsibil ity for sample content only.
END OF REPORT
Ana d al Chemist, B.Se.
IYX.
AISK proficient
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NOTICE: IF THE DOCUMENT IN THIS FRAME IS LESS CLEAR THAN THIS NOTICE
IT IS DUE TO THE QUALITY OF THE DOCUMENT.
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FINAL PROJECT APPROVAL FORM
TO:
DATE:.
MEM IT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
I I AS 11 SIGN
)[_k:�ENGINEERING DIVISION DATE 4_7
PLANNING DIVISION DATE
PLEASE SIGN
PROJECT I C� ��O/ co
SITE ADDRESS— /al a-_ r"I
PERMIT ADB# -DATE INSPECTED IeOI2-& AV' ;"-
DESCRIPTION OF WORK TO BE INSPECTED
\_' r*' _V
A ffild inspection was conducted to determine compliance with -approved plans. Final approval
deno:es that there are no objections from the above signed Department to the release of
PER TORMANCE BONDS and the granting of:
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
El Copy of CONDITIONS given to owner/contractor by inspector
OUTSTANDING ISSUES
FAT ED FINAL INSPECTION
0 Copy of CORRECTION NOTICE given to owner/contractor by inpector
Da
He�
2.
3.
qSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Signature
:b1dg:rorms:ocaprv1 3/25/04
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PERMIT#:
EXPIRES: f-�I-zsllll,
I S S U E D: Z,5h)
%-,ity oi mimonu
THIS CARD MUST BE POSTED ON SITE AND AVAILABLE TO THE INSPECTOR
Owner: 411
SiteAddress:
Prniect: W411 b
,0411i ly4th,-�l 4aA,4� 0
SoiintFiloise originating froin temporary constrLiCtion sites as a result of
const,*uction are exempt from the noise linlits of' ECC Chapter
5.30 only during �Ile 110LIN of' 7:00ain to 6:00pni oil weekdays ',111d
10:00am mid 6:00pin oil Saturdays, exclilding SlIndOyS W10 Federal
Holidays. At all otlic" ti'lles the noise originating 1'roin construction
si tes!act i vi ties 11111st Comply witil tile noise linlits OfChaptcr 5.30, unless
-SL1,111t to ECC 5.30.120.
has been granted JIL11
Setbacks for
Zone
Front C.�
Rear:
Side:
Height:
Variance #:
Inspections
Approved
Date
Notes
#1 ENGINEERING
MOBILIZATION AND EROSION CONTROL INSTALLATION MUST
(425) 771-0220 x1326 Mobilization / Erosion Control
Tijjhtline
Detention
Forms (sidewalk, dHveway)
Water Service
BEXPPROVED
PRIORTo
-7/*-24,1.4
COMMENCEMENT OF ADDITIONAL WORK.
;I-lk- Q-64 Aqr -6ileek, -
- - - - - - - - - - - - - - - - - - - --
- - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - -
—
Permit # Side Sewer
Permit # Right -of -Way
(s/w, c/g, paving)
#2 SITE/DEMOLITION Pre -Demolition
Asbestos SAPCA Permit
Sewer Cap
Cleaned Site/Final
3
1±
77t - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - - -
—
—
—
#3 FOUNDATION Setbacks
Footings
Foundation Wall
Piers
Retaining- Wall
Slab Insulation
—
- - - - - - - - - - - - - - - -- - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - - - -
1 #4 PLUMBING Ground Work
Permit #_TM61q6�C1 Rough In
Grease Fixture
- - - - - - - - - - - - - - - - - - -
0 -- - - - - - - - - - - - - - - - - - - - -
#5 PUBLIC WORKS Cross Connection Control
(425) 771-0235
#6 MECH/HVAC Gas ljg/Pipe
P�!rmit #_TIV(�14 Equipmentety��A4-
- - - - --- - - - - - - - - - - - - - - - - - -
#7 FRAMING Exterior Sheathinp-
Shear Nailing_
First Floor Framing
Framing
Height Check
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - - ---
- - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - - -
11
#8 INSULATE / CAULK
OW FIRE
(4Z&Y-" �-5
[I
allut
MrA
IF
17L
Addressing Visibility I
FINAL PROJECT
Engl'qe_e* fA A A,
OVALS ***
Z7, Plannin
Fl�
EL OCCUPANCY APPROVAL *1
*** FINA
G INSPECTOR
THIS BQILDING OR ANY PORTION THEREOF I NOT TO BE OCCUPIED PER QBQ 109, UNTIL ALL
APPLICABLE CITY DEPARTMENTS HAVE GRANTED A FINAL APPRO L
Call (425) 771-0220 x1333 for BUILDING INSPECTIONS
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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.................
I Final .......
Commercia
ATHING
EXTERIOR SHE
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING...
INSULATION ...................
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
(Lk -CU-1y"E" vr\ls
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
e&q VIP
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